WorldWideScience

Sample records for surgery significant differences

  1. Prognostic significance of delayed structural recovery after macular hole surgery

    DEFF Research Database (Denmark)

    Christensen, Ulrik C; Krøyer, Kristian; Sander, Birgit

    2009-01-01

    PURPOSE: To assess the prognostic significance for visual function of persistent subfoveal fluid and persistent photoreceptor layer discontinuity in eyes in which hole closure had been obtained 3 months after macular hole surgery. DESIGN: Ancillary study of subjects enrolled in a randomized...... clinical trial. PARTICIPANTS: Participants were recruited from a randomized clinical trial evaluating internal limiting membrane (ILM) peeling in macular hole surgery. The study included 74 eyes in which a contiguous retinal surface or a full attachment with a flat neuroretinal rim had been reestablished...... OUTCOME MEASURES: Postoperative foveal configuration and foveal photoreceptor layer discontinuity diameter 3 months after macular hole surgery. RESULTS: Persistent subfoveal fluid 3 months after macular hole surgery, which was found in 36.5% of eyes, was not associated with a significantly different BCVA...

  2. Clinical significance of computed tomography assessment for third molar surgery

    Institute of Scientific and Technical Information of China (English)

    Kenji; Nakamori; Kei; Tomihara; Makoto; Noguchi

    2014-01-01

    Surgical extraction of the third molar is the most commonly performed surgical procedure in the clinical practice of oral surgery.Third molar surgery is warranted when there is inadequate space for eruption,malpositioning,or risk for cyst or odontogenic tumor formation.Preoperative assessment should include a detailed morphologic analysis of the third molar and its relationship to adjacent structures and surrounding tissues.Due to developments in medical engineering technology,computed tomography(CT)now plays a critical role in providing the clear images required for adequate assessment prior to third molar surgery.Removal of the maxillary third molar is associated with a risk for maxillary sinus perforation,whereas removal of the mandibular third molar can put patients at risk for a neurosensory deficit from damage to the lingual nerve or inferior alveolar nerve.Multiple factors,including demographic,anatomic,and treatment-related factors,influence the incidence of nerve injury during or following removal of the third molar.CT assessment of the third molar prior to surgery can identify some of these risk factors,such as the absence of cortication between themandibular third molar and the inferior alveolar canal,prior to surgery to reduce the risk for nerve damage.This topic highlight presents an overview of the clinical significance of CT assessment in third molar surgery.

  3. Clinical significance of computed tomography assessment for third molar surgery.

    Science.gov (United States)

    Nakamori, Kenji; Tomihara, Kei; Noguchi, Makoto

    2014-07-28

    Surgical extraction of the third molar is the most commonly performed surgical procedure in the clinical practice of oral surgery. Third molar surgery is warranted when there is inadequate space for eruption, malpositioning, or risk for cyst or odontogenic tumor formation. Preoperative assessment should include a detailed morphologic analysis of the third molar and its relationship to adjacent structures and surrounding tissues. Due to developments in medical engineering technology, computed tomography (CT) now plays a critical role in providing the clear images required for adequate assessment prior to third molar surgery. Removal of the maxillary third molar is associated with a risk for maxillary sinus perforation, whereas removal of the mandibular third molar can put patients at risk for a neurosensory deficit from damage to the lingual nerve or inferior alveolar nerve. Multiple factors, including demographic, anatomic, and treatment-related factors, influence the incidence of nerve injury during or following removal of the third molar. CT assessment of the third molar prior to surgery can identify some of these risk factors, such as the absence of cortication between the mandibular third molar and the inferior alveolar canal, prior to surgery to reduce the risk for nerve damage. This topic highlight presents an overview of the clinical significance of CT assessment in third molar surgery.

  4. Significant Resolution of Female Sexual Dysfunction after Bariatric Surgery

    Science.gov (United States)

    Bond, Dale S.; Wing, Rena R.; Vithiananthan, Sivamainthan; Sax, Harry C.; Roye, G. Dean; Ryder, Beth A.; Pohl, Dieter; Giovanni, Jeannine

    2010-01-01

    Background We previously reported that the majority of women seeking bariatric surgery had female sexual dysfunction (FSD) as defined by the validated Female Sexual Function Index (FSFI). Objective The current study examined whether FSD resolves after bariatric surgery. Setting The Miriam Hospital, Providence RI, USA. Methods Fifty-four reportedly sexually active women (43.3±9.5 years) completed the FSFI pre- and 6-months post-operatively after a mean excess weight loss (%EWL) of 42.3% [Laparoscopic adjustable gastric banding (LAGB) n=38; %EWL=34.6±15.7; Roux-en-Y gastric bypass (RYGB) n=16; %EWL=60.0±21.2). The FSFI assesses sexual function across six domains with higher scores indicating better sexual function. Summing of these scores yields a FSFI-total score (range=2–36 with ≤26.55=FSD). Results Before surgery, 34 women (63%) had scores indicative of FSD. By 6-months after surgery, FSD had resolved in 23 of these 34 (68%) women, and only 1 woman developed FSD. In the entire sample, there were significant (p<0.05) improvements from pre- to post-surgery on all FSFI domains. FSFI-total scores improved after LAGB (24.2±5.9 to 29.1±4.1, p<0.001) and RYGB (23.7±7.7 to 30.0±4.7, p<0.001). In regression analyses, being married, younger age, and worse preoperative sexual function were related to greater sexual function improvements. Postoperatively, participants’ FSFI-total scores were indistinguishable from published normative controls (29.4±4.3 vs. 30.5±5.3, p=0.18). Conclusion FSD resolved in a large percentage of women. Sexual functioning in the entire sample improved to levels consistent with normative controls. This improvement in sexual function did not depend on surgery type or weight loss amount, and appears to be an additional benefit for women undergoing bariatric surgery. PMID:20678969

  5. Troponin elevation after noncardiac surgery: Significance and management.

    Science.gov (United States)

    Horr, Samuel; Reed, Grant; Menon, Venu

    2015-09-01

    How to interpret and manage troponin elevations after noncardiac surgery is a common clinical question for cardiologists and internists. An estimated 5% to 25% of patients who undergo noncardiac surgery have an elevated postoperative troponin level. Patients with troponin elevation are at higher short-term and long-term risk of morbidity and mortality. Current guidelines provide few recommendations on how to manage these patients. The authors review the evidence and guidelines and propose treatment strategies.

  6. Teaching plastic surgery from different perspectives.

    Science.gov (United States)

    Cable, Christian; Chong, Tae; Pratt, Daniel D

    2012-06-01

    Just as everyone has a different learning style, teachers too approach the task from different perspectives. There are five basic teaching perspectives or styles: transmission, apprenticeship, developmental, nurturing, and social justice. The acronym BIAS is useful to describe the beliefs, intentions, assessments, and strategies associated with each perspective. The authors present a hypothetical 1-week rotation in plastic and reconstructive surgery in which a student encounters instructors who embody the five basic teaching perspectives. By presenting these perspectives, the authors introduce valuable teaching techniques that can benefit all those charged with the education of learners along the spectrum from premedical to continuing education venues. Educational objectives include the following: (1) explain and illustrate different approaches to effective teaching in plastic surgery; (2) introduce readers to the Teaching Perspectives Inventory as a means of determining their primary teaching style; and (3) argue for a "plurality of the good" in teaching.

  7. In surgeons performing cardiothoracic surgery is sleep deprivation significant in its impact on morbidity or mortality?

    Science.gov (United States)

    Asfour, Leila; Asfour, Victoria; McCormack, David; Attia, Rizwan

    2014-09-01

    A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: is there a difference in cardiothoracic surgery outcomes in terms of morbidity or mortality of patients operated on by a sleep-deprived surgeon compared with those operated by a non-sleep-deprived surgeon? Reported search criteria yielded 77 papers, of which 15 were deemed to represent the best evidence on the topic. Three studies directly related to cardiothoracic surgery and 12 studies related to non-cardiothoracic surgery. Recommendations are based on 18 121 cardiothoracic patients and 214 666 non-cardiothoracic surgical patients. Different definitions of sleep deprivation were used in the studies, either reviewing surgeon's sleeping hours or out-of-hours operating. Surgical outcomes reviewed included: mortality rate, neurological, renal, pulmonary, infectious complications, length of stay, length of intensive care stay, cardiopulmonary bypass times and aortic-cross-clamp times. There were no significant differences in mortality or intraoperative complications in the groups of patients operated on by sleep-deprived versus non-sleep-deprived surgeons in cardiothoracic studies. One study showed a significant increase in the rate of septicaemia in patients operated on by severely sleep-deprived surgeons (3.6%) compared with the moderately sleep-deprived (0.9%) and non-sleep-deprived groups (0.8%) (P = 0.03). In the non-cardiothoracic studies, 7 of the 12 studies demonstrated statistically significant higher reoperation rate in trauma cases (P sleep deprivation in cardiothoracic surgeons on morbidity or mortality. However, overall the non-cardiothoracic studies have demonstrated that operative time and sleep deprivation can have a significant impact on overall morbidity and mortality. It is likely that other confounding factors concomitantly affect outcomes in out-of-hours surgery. © The Author 2014. Published by Oxford University Press on behalf of

  8. Apnea–hypopnea index decreased significantly after nasal surgery for obstructive sleep apnea

    Science.gov (United States)

    Wu, Jun; Zhao, Guoqiang; Li, Yunchuan; Zang, Hongrui; Wang, Tong; Wang, Dongbo; Han, Demin

    2017-01-01

    Abstract Background: Nasal surgeries have been applied to obstructive sleep apnea (OSA) patients with nasal obstruction for decades. However, the efficiency of nasal surgery in improving OSA remains controversial. The aim of this study was to identify whether isolated nasal surgery can improve apnea–hypopnea index (AHI). Methods: Computerized searches were performed in MEDLINE, Web of Science, Cochrane Library, and Scopus from January 1, 2000 to April 30, 2016. A total of 18 articles and 587 participants were included. There were 1 randomized controlled trials, 2 nonrandomized trials, 11 prospective studies, and 4 retrospective studies. Data regarding study design (prospective/retrospective clinical trial, randomized, and controlled), population size, participant characteristics (age, gender, and body mass index), surgical intervention, and outcomes (AHI, Epworth sleep scale [ESS]) was collected. Results: Statistically significant improvement in AHI (subgroup 1: weighted mean difference [WMD] [95%confidence interval (CI)], −4.17 [−7.62, −0.73]; subgroup 2: WMD [95%CI], −4.19 [−7.51, −0.88]; overall: WMD [95%CI], −4.15 [−6.48, −1.82]) and ESS (subgroup 1: WMD [95%CI], −2.14 [−3.08, −1.19]; subgroup 2: WMD [95%CI], −4.70 [−5.95, −3.44]; overall: WMD [95%CI], −4.08 [−5.27, −2.88]) was revealed. Conclusion: Both AHI and ESS improved significantly after isolated nasal surgery, but the improvement of AHI is slightly significant. Future randomized controlled trials are needed to confirm the long-term benefits of nasal surgery on OSA. PMID:28151900

  9. Significant differences in cross cultural negotiations

    OpenAIRE

    Luminita Vochita

    2008-01-01

    This paper analyses the importance of different factors that influences cross cultural negotiations. Learning about the components of a cross cultural negotiation process to increase negotiators’ success in avoiding barriers and failures in the international business arena is one of the most challenging achievements of the negotiators in the global environment. In the second part, the paper focuses on the one of the most important componenet of cross cultural business negotiations: difference...

  10. Changes in mandibular mobility after different procedures of orthognathic surgery.

    Science.gov (United States)

    Zimmer, B; Schwestka, R; Kubein-Meesenburg, D

    1992-06-01

    A prospective study including 63 adult Class II and Class III patients was carried out in order to examine short- and long-term effects of four different treatment methods on mandibular mobility. The patients were treated either (Group A, control-group) orthodontically alone or (Group B) by a LeFort I-osteotomy, a (Group C) mandibular advancement or (Group D) a two-jaw surgery/mandibular set-back. In the surgery-groups (B, C, and D) maximum opening, protrusion and lateral excursions were measured 2 days pre-operatively (T0), and 3, 8, 14.5, and 25.5 months post-operatively (T1-T4). In the control-group (A) at T0 and T4 was measured, only. Significantly differing effects of the four treatment methods on mandibular mobility were detected. (A) Orthodontic treatment alone, (B) maxillary advancement by LeFort I osteotomy, and (D) two-jaw surgery/mandibular set-back osteotomy did not influence mandibular mobility permanently. Temporary decreases in groups B and D (P less than or equal to 0.05) were observed, however. In contrast, permanent reductions after (C) mandibular advancement took place (P less than or equal to 0.001). Longitudinal survey showed that in all surgery groups recoveries were limited to a short period of 3-14.5 months, depending on the movement. Surprisingly, a closer similarity between the LeFort-I group (B) and the two-jaw surgery group (D), rather than between the sagittal-split groups (C and D), was seen indicating that the problem of reduced mobility after orthognathic surgery can be limited to Class II therapy. It was concluded that in Class III therapy, the application of rigid fixation in combination with a method of maintaining condyle-position, thereby dispensing with maxillomandibular fixation, prevents permanent reductions in mobility and guarantees a rapid recovery to pre-operative mobility levels.

  11. Significance of time scale differences in psychophysics.

    Science.gov (United States)

    Klonowski, W

    2009-02-01

    We present modeling of both rational processes (thoughts) and emotional processes (feelings) on a two-dimensional lattice and on extremely simplified two-dimensional phase space of the brain. Our purpose is to analyze influence of differences in time-scales of various types of processes. In particular, we show that no 'central executive structure' between consciousness and unconsciousness, the existence of which was suggested by psychologists, is not needed.

  12. Right versus left stapes surgery: is there a difference?

    Science.gov (United States)

    Karkas, Alexandre; Chahine, Karim; Righini, Christian Adrien; Khirnetkina, Ayuna; Schmerber, Sébastien

    2009-12-01

    To search for a statistically significant difference in auditory results between right and left ears after surgery for otosclerosis. Retrospective case-review study. Academic tertiary referral center. Eight hundred ninety-four cases of stapes surgery were reviewed. Patients were divided into 2 groups: right ear (474 cases) and left ear (420 cases). There were 4 classes in each group depending on the preoperative air-bone gap (ABG). Each class was divided into 3 subclasses depending on the preoperative bone conduction (BC). Two parameters were analyzed: ABG and BC. The parameters compared between right and left ears were 1) the difference between mean preoperative and 4-month postoperative ABG (DeltaABG) and 2) the difference between mean preoperative and 4-month postoperative BC (DeltaBC). We used the analysis of variance statistical test. Furthermore, we calculated the number of patients who have had postoperative sensorineural hearing loss at 4 months defined as a fall in BC of more than 10 dB and compared the results between right and left ears using chi test. There was no statistically significant difference in the DeltaABG and the DeltaBC between the right and left ear (p = 0.742 and 0.426, respectively) taking into consideration all classes and subclasses. We found 19 cases of postoperative sensorineural hearing loss, among which are 10 right ears and 9 left ears. The difference was not statistically significant (p = 0.973). There is no functional difference between stapes surgery performed in the right ear as compared with that performed in the left ear.

  13. Cardiac troponin I and creatine kinase-MB release after different cardiac surgeries.

    Science.gov (United States)

    Mastro, Florinda; Guida, Pietro; Scrascia, Giuseppe; Rotunno, Crescenzia; Amorese, Lillà; Carrozzo, Alessandro; Capone, Giuseppe; Paparella, Domenico

    2015-06-01

    To conduct a comparative study of cardiac troponin I (cTnI) and MB isoenzyme of serum creatine kinase (CK-MB) after different cardiac surgeries. Consecutive cardiac operations under cardiopulmonary bypass (200 adults, 144 men, 68 ± 11 years): 67 coronary artery bypass graft (CABG), 27 aortic valve surgery, 21 mitral valve surgery, 11 thoracic aorta surgery, and 74 combined surgery. Postoperative cTnI and CK-MB were measured on admission to the ICU and at fixed time until the fifth postoperative day. Peak values of cTnI (median 5.8 ng/ml; interquartile range 3.6-11.9) and CK-MB (29.0 ng/ml; 15.6-60.4) were reached mainly within 18 h after the end of surgery (85% of cTnI and 95% of CK-MB highest determinations) without differences among groups. Cardiopulmonary bypass and cross-clamp time significantly correlated with markers' peak values. At multivariate analysis, mitral valve surgery showed greater cTnI, CK-MB, and their cumulative area under the curve than other isolated procedures. Thoracic aorta surgery showed lower cumulative area under the curve for both markers than CABG and combined surgery. Mitral valve surgery had significant later reduction of both markers in comparison with other procedures. No patient in mitral valve surgery group reached cTnI values in the normal laboratory range within 5 postoperative days. Release pattern of cTnI and CK-MB after heart surgery depends on the type of procedure. Mitral valve surgery was characterized by highest and longest elevation of postoperative markers' concentration. Determinants of differences in myocardial injury biomarkers and their prognostic value after valve surgery should be accurately assessed.

  14. Significant factors associated with fatal outcome in emergency open surgery for perforated peptic ulcer

    Institute of Scientific and Technical Information of China (English)

    Mario Testini; Piero Portincasa; Giuseppe Piccinni; Germana Lissidini; Fabio Pellegrini; Luigi Greco

    2003-01-01

    AIM: To evaluate the main factors associated with mortality in patients undergoing surgery for perforated peptic ulcer referred to an academic department of general surgery in a large southern Italian city.METHODS: One hundred and forty-nine consecutive patients (M:F ratio=110:39, mean age 52 yrs, range 16-95) with peptic ulcer disease were investigated for clinical history (including age, sex, previous history of peptic ulcer, associated diseases, delayed abdominal surgery, ulcer site, operation type, shock on admission, postoperative general complications,and intra-abdominal and/or wound infections), serum analyses and radiological findings.RESULTS: The overall mortality rate was 4.0%. Among all factors, an age above 65 years, one or more associated diseases, delayed abdominal surgery, shock on admission,postoperative abdominal complications and/or wound infections, were significantly associated (χ2) with increased mortality in patients undergoing surgery (0.0001<P<0.03).CONCLUSION: Factors such as concomitant diseases, shock on admission, delayed surgery, and postoperative abdominal and wound infections are significantly associated with fatal outcomes and need careful evaluation within the general workup of patients admitted for perforated peptic ulcer.

  15. [A significant increase in intraoperative flash visual evoked potential amplitude during craniopharyngioma surgery-case report].

    Science.gov (United States)

    Kawaguchi, Tomohiro; Ogawa, Yoshikazu; Fujiwara, Satoru; Tominaga, Teiji

    2015-04-01

    The flash visual evoked potential (VEP) is a useful diagnostic modality for visual preservation during surgery. Decreased VEP amplitude is recognized to indicate visual deterioration;however, whether intraoperative VEP can detect visual improvement remains unclear. We describe a craniopharyngioma case with a significant increase in VEP amplitude during surgery. A 67-year-old woman presented with progressive gait disturbance and impaired consciousness. Head magnetic resonance imaging demonstrated a sellar-suprasellar tumor compressing the optic chiasm upward with significant ventricular dilation. Her Glasgow Coma Scale was E3V3M5. Visual fields and acuity could not be examined because of impaired consciousness, and she could not see/recognize objects on a table. Preoperative VEP showed reproducible waveforms. Tumor removal by the extended transsphenoidal approach was performed with VEP monitoring. Increased VEP amplitude was observed after dural incision and persisted until the surgery ended. Postoperative VEP waveforms were also reproducible, but visual fields/acuity could not be examined because of cognitive dysfunction. Useful visual function was restored, and she became independent in daily life. The histological diagnosis was craniopharyngioma. The patient underwent ventriculo-peritoneal shunting for hydrocephalus 16 days after tumor removal. The postoperative course was uneventful and she was transferred to another hospital for rehabilitation. Intraoperative VEP may indicate visual improvement during surgery, which is a useful objective assessment for visual function in patients with impaired consciousness and cognitive dysfunction.

  16. Detection methods and clinical significance of free peritoneal tumor cells found during colorectal cancer surgery

    Institute of Scientific and Technical Information of China (English)

    Simone; Sibio; Cristina; Fiorani; Carmine; Stolfi; Andrea; Divizia; Roberto; Pezzuto; Fabrizio; Montagnese; Giulia; Bagaglini; Paolo; Sammartino; Giuseppe; Sigismondo; Sica

    2015-01-01

    Peritoneal washing is now part of the standard clinical practice in several abdominal and pelvic neoplasias. However, in colorectal cancer surgery, intra-peritoneal free cancer cells(IFCC) presence is not routinely investigated and their prognostic meaning is still unclear. When peritoneal washing results are positive for the presence of IFCC a worse outcome is usually expected in these colorectal cancer operated patients, but it what is not clear is whether it is associated with an increased risk of local recurrence. It is authors’ belief that one of the main reasons why IFCC are not researched as integral part of the routine staging system for colon cancer is that there still isn’t a diagnostic or detection method with enough sensibility and specificity. However, the potential clinical implications of a routine research for the presence IFCC in colon neoplasias are enormous: not only to obtain a more accurate clinical staging but also to offer different therapy protocols, based on the presence of IFCC. Based on this, adjuvant chemotherapy could be offered to those patients found to be positive for IFCC; also, protocols of proactive intraperitoneal chemotherapy could be applied. Although presence of IFCC appears to have a valid prognostic significance, further studies are needed to standardize detection and examination procedures, to determine if there are and which are the stages more likely to benefit from routine search for IFCC.

  17. Detection methods and clinical significance of free peritoneal tumor cells found during colorectal cancer surgery.

    Science.gov (United States)

    Sibio, Simone; Fiorani, Cristina; Stolfi, Carmine; Divizia, Andrea; Pezzuto, Roberto; Montagnese, Fabrizio; Bagaglini, Giulia; Sammartino, Paolo; Sica, Giuseppe Sigismondo

    2015-09-27

    Peritoneal washing is now part of the standard clinical practice in several abdominal and pelvic neoplasias. However, in colorectal cancer surgery, intra-peritoneal free cancer cells (IFCC) presence is not routinely investigated and their prognostic meaning is still unclear. When peritoneal washing results are positive for the presence of IFCC a worse outcome is usually expected in these colorectal cancer operated patients, but it what is not clear is whether it is associated with an increased risk of local recurrence. It is authors' belief that one of the main reasons why IFCC are not researched as integral part of the routine staging system for colon cancer is that there still isn't a diagnostic or detection method with enough sensibility and specificity. However, the potential clinical implications of a routine research for the presence IFCC in colon neoplasias are enormous: not only to obtain a more accurate clinical staging but also to offer different therapy protocols, based on the presence of IFCC. Based on this, adjuvant chemotherapy could be offered to those patients found to be positive for IFCC; also, protocols of proactive intraperitoneal chemotherapy could be applied. Although presence of IFCC appears to have a valid prognostic significance, further studies are needed to standardize detection and examination procedures, to determine if there are and which are the stages more likely to benefit from routine search for IFCC.

  18. Clinical significance of radiation therapy in breast recurrence and prognosis in breast-conserving surgery

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Reiki; Nagao, Kazuharu; Miyayama, Haruhiko [Kumamoto City Hospital (Japan)] [and others

    1999-03-01

    Significant risk factors for recurrence of breast cancer after breast-conserving therapy, which has become a standard treatment for breast cancer, are positive surgical margins and the failure to perform radiation therapy. In this study, we evaluated the clinical significance of radiation therapy after primary surgery or breast recurrence. In 344 cases of breast-conserving surgery, disease recurred in 43 cases (12.5%), which were classified as follows: 17 cases of breast recurrence, 13 cases of breast and distant metastasis, and 13 cases of distant metastasis. Sixty-two patients (16.7%) received radiation therapy. A positive surgical margin and younger age were significant risk factors for breast recurrence in patients not receiving postoperative radiation therapy but not in patients receiving radiation therapy. Radiation therapy may be beneficial for younger patients with positive surgical margins. Furthermore, radiation therapy after recurrence was effective in the cases not treated with postoperative radiation but not in cases with inflammatory recurrence. Patients with breast recurrence alone had significantly higher survival rates than did patients with distant metastases regardless of breast recurrence. These findings suggest that the adaptation criteria of radiation therapy for local control must be clarified. (author)

  19. Significance of epicardial fat in the diagnosis of coronary atherosclerosis before heart valve surgery

    Directory of Open Access Journals (Sweden)

    Joanna de Zayas Galguera

    2016-01-01

    Full Text Available Introduction: Epicardial fat has been shown to be related not only with clinical atherosclerosis, but also with subclinical atherosclerosis.Objective: To determine the significance of epicardial fat in the diagnosis of coronary atherosclerosis in patients with valvular heart disease.Method: The study included 62 patients scheduled for valve replacement surgery who had previously undergone invasive coronary angiography. Before surgery, epicardial fat measurement was performed by echocardiogram. Sensitivity, specificity, and positive and negative predictive values were determined, as well as the validity index and likelihood ratios for positive and negative tests.Results: 88.7% of patients with heart valve disease had no lesions in the coronary arteries. The most relevant parameters obtained from the measurement of epicardial fat were 78% sensitivity and 93% negative predictive value, and a ratio of positive and negative likelihood of 2.23 and 0.34 respectively.Conclusions: The group of patients with significant coronary lesions showed higher levels of epicardial fat than the group without coronary lesions. It confirms the diagnostic validity of this test for the detection of coronary atherosclerosis in the study patients.

  20. Prevalence and significance of gallium-67 uptake in the heart after open-heart surgery

    Energy Technology Data Exchange (ETDEWEB)

    Huikuri, H.V.; Ikaeheimo, M.J.A.; Airaksinen, J.; Linnaluoto, M.M.; Heikkilae, J.T.; Takkunen, J.T.

    1988-02-01

    Radioactive gallium-67 (Ga-67) has been shown to accumulate within areas of pericardial inflammation. The present study estimated prospectively the prevalence and clinical significance of Ga-67 uptake in the heart in 62 patients 10 to 16 days after open-heart surgery. Of 62 patients studied, markedly diffuse Ga-67 uptake was detected in 21 (34%) and focal or mild diffuse uptake in 23 (37%). Results were negative in 18 (29%). Nine patients with a negative scan result (50%) had received corticosteroid therapy before imaging, whereas only 2 patients with a positive scan result (5%) were receiving steroids. The erythrocyte sedimentation rate and C-reactive protein level were both higher in patients with Ga-67 uptake compared with those with a negative scan result (p less than 0.01 in both). No other clinical, echocardiographic or electrocardiographic indicators of postpericardiotomy syndrome were related to Ga-67 uptake. No patient developed cardiac tamponade or constrictive pericarditis during the 12-week follow-up and the Ga-67 scan results did not predict the occlusion of coronary artery bypass grafts. Thus, pericardial inflammation manifested as Ga-67 uptake is a common finding after open-heart surgery and appears to be a benign condition.

  1. Clinical significance of hepatic artery variations originating from the superior mesenteric artery in abdominal tumor surgery

    Institute of Scientific and Technical Information of China (English)

    HUANG Yuan; LIU Chao; LIN Jin-ling

    2013-01-01

    Background Hepatic artery variations are frequent clinical occurrences.The aim of this study was to investigate the characteristic course of variant hepatic arteries originating from the superior mesenteric artery for the purpose of providing instructions for abdominal tumor surgery.Methods The course of variant hepatic arteries originating from the superior mesenteric artery was studied in 400 patients with liver cancer confirmed by digital subtraction angiography (DSA) and multi-slice spiral computed tomography angiography (MSCTA),and 86 patients with gastric cancer confirmed by preoperative MSCTA between June 2008 and June 2010 in the First Affiliated Hospital of Guangxi Medical University.Results Hepatic artery variations originating from the superior mesenteric artery were noticed in 49 liver cancer patients and 14 gastric cancer patients (total 63 cases),with a variation rate of 12.96%,including two cases (3.17%) where the hepatic arteries ran along the anterior pancreas,and 61 cases (96.83%) where the hepatic arteries ran along the posterior pancreas.Conclusions Hepatic artery variations originating from the superior mesenteric artery present as two types:the pre-pancreas type and the post-pancreas type with the latter predominating.This finding is of clinical significance in abdominal tumor surgeries where clearance of portal lymph nodes is needed.

  2. Significant differences in late Quaternary bedrock erosion and transport

    DEFF Research Database (Denmark)

    Andrews, John; Bjørk, Anders Anker; Eberl, Dennis;

    2015-01-01

    We use quantitative X-ray diffraction to determine the mineralogy of late Quaternary marine sediments from the West and East Greenland shelves offshore from early Tertiary basalt outcrops. Despite the similar basalt outcrop area (60 000–70 000 km2), there are significant differences between East ...

  3. Short term general anesthesia for retro-bulbar block in ophthalmic surgery generates no significant hypercapnia.

    Science.gov (United States)

    Baulig, Werner; Weber, Monica; Beck-Schimmer, Beatrice; Theusinger, Oliver M; Biro, Peter

    2017-03-11

    To assess the impact of short time hypnosis for retro-bulbar anesthesia on ventilation in patients undergoing ophthalmic surgery of the anterior eye chamber. In all patients, a combined continuous transcutaneous carbon dioxide tension (PtcCO2) and partial oxygen saturation (SpO2) measurement was applied in addition to routine monitoring. To enable unconscious application of retro-bulbar anesthesia, intravenous thiopental was given in one to multiple bolus doses. Transient breathing support included chin lift, Esmarch maneuver and manual hand-bag ventilation via face mask. Main endpoints were apnea time, recovery time according to the Richmond Agitation Sedation Scale, as well as SpO2 and PtcCO2 readings at predefined time points. Fifty-two patients with a mean age of 68 ± 13 years were included. Average thiopental dose was 2.7 ± 0.6 mg/kg. In seven (13.5%) patients repeated doses of thiopental were necessary to a total of 3.3 ± 1.1 mg/kg. Except one patient, no severe, significant or clinical relevant hypercapnia or desaturation periods were observed, and the occurring elevation of PtcCO2 values did not correlate with the application of repeated doses of thiopental or the need for the Esmarch maneuver. Higher PtcCO2 values were associated with the presence of hypertension and smoking. Apnea (p < 0.001) and recovery (p = 0.003) time were significantly prolonged in the patients needing the Esmarch maneuver. Short term anesthesia with thiopental in ophthalmic surgery is associated with a mild but not clinically relevant hypercapnia.

  4. Significant improvement in dynamic visual acuity after cataract surgery: a promising potential parameter for functional vision.

    Directory of Open Access Journals (Sweden)

    Mingxin Ao

    Full Text Available PURPOSE: Dynamic visual acuity (DVA is a relatively independent parameter for evaluating the ability to distinguish details of a moving target. The present study has been designed to discuss the extent to which age-related cataract impacts DVA in elderly individuals and to determine whether it could be restored after bilateral phacoemulsification combined with intraocular lens implantation surgery. METHODS: Twenty-six elderly cataract patients scheduled for binocular cataract surgery and 30 elderly volunteers without cataract were enrolled in the study. DVA at 15, 30, 60 and 90 degree per second (dps was assessed, and velocity-dependent visual acuity decreases between consecutive speed levels were calculated. RESULTS: Compared with the control group, the patient group exhibited significantly worse DVA performance at all speed levels (p<0.001, and the decreases in velocity-dependent visual acuity were more serious in the patient group at the intervals of 0-15 dps (p<0.001, 15-30 dps (p = 0.007 and 30-60 dps (p = 0.008. Postoperatively, DVA performance at every speed level in the patient group clearly improved (p<0.001 and recovered to levels compatible to the control group. The decrease in visual acuity with increasing speed was less pronounced than during the preoperative phase (p0-15 dps = 0.001, p15-30 dps<0.001 and p30-60 dps = 0.001 and became similar to that of the control group. The postoperative visual benefit regarding DVA was more pronounced than the improvement in static visual acuity (p15 dps = 0.001 and p<0.001 at 30 dps, 60 dps and 90 dps. CONCLUSIONS: The impact of age-related cataract on DVA was more severe than its effects on static visual acuity. After cataract surgery, not only static vision of the patients was restored markedly, but also the dynamic vision. DVA could be an important adjunct to the current evaluation system of functional vision, thereby meriting additional attention in clinical assessment.

  5. Clinical significance of serum cortisol levels following surgery for congenital heart disease.

    Science.gov (United States)

    Teagarden, Alicia M; Mastropietro, Christopher W

    2017-03-01

    Use of hydrocortisone to treat refractory haemodynamic instability in patients recovering from surgery for congenital heart disease is common practice at many centres. We aimed to determine whether there is a relationship between total serum cortisol concentrations and haemodynamic response to this therapy. Material and methods We retrospectively reviewed patients cortisol measurements contemporaneous with its administration. Favourable responders were defined as patients in whom, at 24 hours after hydrocortisone initiation, either (1) systolic blood pressure was increased or unchanged and vasoactive-inotrope score was decreased or (2) systolic blood pressure increased by ⩾10% of baseline and vasoactive-inotrope score was unchanged. Variables were compared using t-tests or Mann-Whitney U tests as appropriate. In total, 24 patients were reviewed, with a median age of 1.4 months and range of 0.1-232 months. Among them, 14 (58%) patients responded favourably to hydrocortisone. At 24 hours, the median change in vasoactive-inotrope score was -18% in favourable responders and +31% in those who did not respond favourably, p=0.001. The mean pre-hydrocortisone total serum cortisol in favourable responders was 17.4±10.9 µg/dl compared with 46.1±44.7 µg/dl in those who did not respond favourably, p=0.03. Total serum cortisol obtained before initiation of hydrocortisone was significantly lower in patients who responded favourably to this therapy. Total serum cortisol may therefore be helpful in identifying children recovering from cardiac surgery who may or may not haemodynamically improve with hydrocortisone.

  6. The significance of cultural differences overcome in acquisition processes

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    Đorđević Slaviša

    2012-01-01

    Full Text Available Besides the high merger failure rate, different types of corporation restructuring are still one of the most popular ways to realize particular strategic goals, as well as the identified and anticipated synergy effects. In this article we tried to point at the significance that might have cultural integration on the final derived transactions of two entities or new culture development in acquisition processes.

  7. Comparative study on effect of different surgeries for vision and ocular tissues in leprosy patients with lagophthalmos

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    Jian-Sheng Hu

    2017-09-01

    Full Text Available AIM:To study the effect of different surgeries for vision and postoperative complications in leprosy patients with lagophthalmos.METHODS: A retrospective analysis. Totally 68 leprosy patients(97 eyeswith lagophthalmos were selected who treated with different surgeries during May 2007 to September 2015 in our sanatorium. The surgeries included nylon thread correction surgery, tarsorrhaphy, temporalis transposition surgery. We observed and compared the best corrected visual acuity(BCVAand the rate of postoperative complications, such as epiphora, lacrimal duct injury, hard to open eyes, infection at the inner and lateral canthus and scar formation of lacrimal apparatus.RESULTS: The effect on BCVA of patients treated with nylon thread correction surgery and tarsorrhaphy: the preoperative and postoperative BCVA was significantly different of the two groups(Z=-4.193, -4.213; PZ=-1.532, P >0.05. The postoperative complications:(1epiphora: there was 91% in patients underwent nylon thread correction surgery, 89% in patients underwent tarsorrhaphy, 59% in patients underwent temporalis transposition surgery, the difference was statistically significant(χ2=12.198, Pχ2=22.415, Pχ2=8.795, Pχ2=60.858, PCONCLUSION: There are certain clinical efficacy for lagophthalmos caused by leprosy after surgery, especially patients after temporalis transposition surgery can close eyes by oneself. And their vision does not change significantly, which suggests that this surgery may prevent exposure injury for cornea. But the iatrogenic injury, the vision decrease in patients underwent other surgeries and the ocular tissue damage, such as epiphora, lacrimal duct injury, hard to open eyes, infection at the inner and lateral canthus and scar formation of lacrimal apparatus should be pay more attention to.

  8. Coagulation tests show significant differences in patients with breast cancer.

    Science.gov (United States)

    Tas, Faruk; Kilic, Leyla; Duranyildiz, Derya

    2014-06-01

    Activated coagulation and fibrinolytic system in cancer patients is associated with tumor stroma formation and metastasis in different cancer types. The aim of this study is to explore the correlation of blood coagulation assays for various clinicopathologic factors in breast cancer patients. A total of 123 female breast cancer patients were enrolled into the study. All the patients were treatment naïve. Pretreatment blood coagulation tests including PT, APTT, PTA, INR, D-dimer, fibrinogen levels, and platelet counts were evaluated. Median age of diagnosis was 51 years old (range 26-82). Twenty-two percent of the group consisted of metastatic breast cancer patients. The plasma level of all coagulation tests revealed statistically significant difference between patient and control group except for PT (p50 years) was associated with higher D-dimer levels (p=0.003). Metastatic patients exhibited significantly higher D-dimer values when compared with early breast cancer patients (p=0.049). Advanced tumor stage (T3 and T4) was associated with higher INR (p=0.05) and lower PTA (p=0.025). In conclusion, coagulation tests show significant differences in patients with breast cancer.

  9. [Influence of different surgeries on growth and development of alar cartilage in young-rabbit].

    Science.gov (United States)

    Jiang, Lian; Dong, Xiqian; Song, Qinggao; Chen, Shang; Zou, Sihai

    2011-01-01

    The purpose of this study is to observe the affection of different clinical surgeries on alar nasal cartilages' growth and development. The experimental results can provide some theory basis for clinical surgeries. Twenty-eight New Zealand immature rabbits were used in this study, and divided into normal control group, hidden dissection group and cutting off alar nasal cartilages group randomly, which included 4,12 and 12 rabbits, separately. Arc incision were made on the mucous membrane of nasal cavity,and then dissect the alar nasal cartilages hidden or cut off the alar nasal cartilages, separately. The growth and development of the alar cartilage were observed at different stages after the surgery using histological and immuno-histochemical methods. Four weeks, eight weeks, twelve weeks and sixteen weeks after surgery, there were no significant differences in the indexes of chondrocytes between hidden dissection group and control group. In cutting off alar nasal cartilages group, fiber tissue were observed in the vacancy left after being cut off cartilages, and even mucous membrane tissue could be seen in some slices. There is no adverse influence on the growth and development of the alar cartilage after being hidden dissected. Contrarily, the restoring capability of transparent cartilage cannot counteract the injury resulted form the surgery after the alar nasal cartilages being cut off.

  10. Do pathological variables have prognostic significance in rectal adenocarcinoma treated with neoadjuvant chemoradiotherapy and surgery?

    Science.gov (United States)

    Reggiani Bonetti, Luca; Lionti, Simona; Domati, Federica; Barresi, Valeria

    2017-01-01

    AIM To clarify which factors may influence pathological tumor response and affect clinical outcomes in patients with locally advanced rectal carcinoma treated with neo-adjuvant chemoradiotherapy and surgery. METHODS Tumor regression grade (TRG) according to the Dworak system and yTNM stage were assessed and correlated with pre-treatment clinico-pathological variables in 215 clinically locally advanced (cTNM stage II and III) rectal carcinomas. Prognostic value of all pathological and clinical factors on disease free survival (DFS) and cancer specific survival (CSS) was analyzed by Kaplan Meier and Cox-regression analyses. RESULTS cN+ status, mucinous histotype or poor differentiation in the pre-treatment biopsy were significantly associated with lower pathological response (low Dworak grade and TNM remaining unchanged/upstaging). Cases showing acellular mucin pools in surgical specimens all had unremarkable clinical courses with no deaths or recurrences during follow-up. Dworak grade had prognostic significance for DFS and CSS. However, compared to the 5-tiered system, a simplified two-tiered grading system, in which grades 0, 1 and 2 were grouped as absent/partial regression and grades 3 and 4 were grouped as total/subtotal regression, was more reproducible and prognostically informative. The two-tiered Dworak system, yN stage, craniocaudal extension of the tumor and radial margin status were significant independent prognostic variables. CONCLUSION Our data suggest that caution should be applied in using a conservative approach in rectal carcinomas with cN+ status, extensive/lower involvement of the rectum and mucinous histotype or poor differentiation. Although Dworak TRG is prognostically significant, a simplified two-tiered system could be preferable. Finally, cases with acellular mucin pools should be carefully evaluated to definitely exclude residual mucinous carcinoma. PMID:28293088

  11. Significance of perfectionism in understanding different forms of insomnia

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    Totić-Poznanović Sanja

    2012-01-01

    Full Text Available Introduction. Studies consistently show a connection between perfectionism as a multidimensional construct with various psychological and psychopathological states and characteristics. However, studies that analyze the connection between this concept and sleep disturbances, especially modalities of insomnia, are rare. Objective. The aim of this study was to examine whether dimensions of perfectionism can explain different forms of insomnia; difficulties initiating sleep (insomnia early, difficulties during the sleep (insomnia middle, waking in early hours of the morning (insomnia late and dissatisfaction with sleep quality (subjective insomnia. Methods. The sample consisted of 254 students of the School of Medicine in Belgrade. Predictive significance of nine perfectionism dimensions, measured by Frost’s and Hewitt’s and Flett’s scales of multi-dimensional perfectionism, related to four modalities of insomnia, measured by a structured questionnaire, was analyzed by multiple linear regression method. Results. Perfectionism dimensions are significant predictors of each of the tested forms of insomnia. Doubt about actions significantly predicts initial insomnia; to other-oriented perfectionism in the negative pole and socially prescribed perfectionism underlie the difficulties during the sleep, while organization and parental criticism underlie late insomnia. Significant predictors of subjective insomnia are personal standards and organization and to other-oriented perfectionism on the negative pole. Three of nine analyzed dimensions were not confirmed as significant; concern over mistakes, parental expectations and self-oriented perfectionism. Conclusion. Various aspects of perfectionism can be considered as a vulnerability factor for understanding some forms of insomnia. Out of all forms of insomnia tested, perfectionism as the personality trait proved to be the most significant for understanding subjective insomnia.

  12. ARE THERE SIGNIFICANT DIFFERENCES BETWEEN DIRECT AND REVERSE GRINDING CIRCUITS?

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    Douglas Batista Mazzinghy

    2014-12-01

    Full Text Available The mining industry is famous for many paradigms regarding different flowsheet designs and the use of new technologies and equipment. In this context, a question often performed to process engineers is: what grinding circuit is more efficient, the direct or the reverse? A precise answer could only be given by experimental data and simulations. Simulations were performed using ModSimTM software considering parameters obtained by batch mill tests of an iron ore sample. The simulations, preliminarily, indicated no significant differences between the two circuit configurations for the sample tested. Subsequently, tests were conducted on a pilot scale with detailed measurement of all the variables necessary for a correct interpretation of the differences between the direct and reverse circuits. The test results confirmed the prediction obtained by simulation. This work provides the basis to test other ores and to understanding better the real differences between grinding circuit configurations. Thus, it is expected that some myths of the mineral industry, with respect to flowsheet choices, are overcome.

  13. Wound classification in pediatric general surgery: significant variation exists among providers.

    Science.gov (United States)

    Snyder, Rebecca A; Johnson, Lisa; Tice, Jamie; Wingo, Tammy; Williams, Dana; Wang, Li; Blakely, Martin L

    2013-11-01

    Risk-adjusted rates of surgical site infections (SSI) are used as a quality metric to facilitate improvement within a hospital system and allow comparison across institutions. The NSQIP-Pediatric, among others, uses surgical wound classification as a variable in models designed to predict risk-adjusted postoperative morbidity, including SSI rates. The purpose of this study was to measure the level of agreement in wound classification assignment among 3 providers: surgeons, operating room (OR) nurses, and NSQIP surgical clinical reviewers (SCR). An analysis was performed of pediatric general surgery operations from 2010 to 2011. Wound classification was assigned at the time of operation by the OR nurse and surgeon, and by the NSQIP SCR postoperatively, according to NSQIP methodology. Disagreement was defined as any discrepancy in classification among the 3 providers, and the level of agreement was determined using the kappa statistic. For the 374 procedures reviewed, there was an overall disagreement of 48% among all providers, kappa 0.48 (95% CI 0.43 to 0.53). When comparing wound classification by surgeon and NSQIP SCR, 23% of cases were in disagreement, kappa 0.74 (95% CI 0.68 to 0.78). Disagreement between OR nurse and either surgeon or NSQIP SCR was higher: 38%, kappa 0.45 (95% CI 0.38 to 0.53) and 40%, kappa 0.44 (95% CI 0.37 to 0.51). Fundoplication, appendectomy, and cholecystectomy demonstrated the highest overall disagreement (73%, 71%, and 60%, respectively). There is significant variation in assigning surgical wound classification among health care providers. For future SSI comparative analyses, it will be critical to improve uniformity and understanding of wound class assignment among providers and institutions. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  14. Is surgery indicated for asymptomatic or mildly myelopathic patients with significant ossification of the posterior longitudinal ligament?

    Science.gov (United States)

    Yonenobu, Kazuo

    2012-03-01

    Review article. To discuss indications and timing of surgery for patients with significant ossification of the posterior longitudinal ligament (OPLL) who show no or only mild myelopathic symptoms. Among patients with cervical spinal cord injury, the incidence of patients with OPLL is relatively high, and most had no obvious symptoms of cervical myelopathy. These topics were discussed on the basis of clinical practice guidelines for ossification of the posterior longitudinal ligament as published in 2005 by the Japanese Orthopaedic Association and the Committee on Research into OPLL under the auspices of the Ministry of Health, Labor and Welfare. No evidence supports the usefulness of surgery for patients with significant OPLL without or with only mild cervical myelopathy. "Prophylactic" surgery for patients with significant OPLL without or with only mild cervical myelopathy cannot be recommended on the basis of the existing evidence.

  15. Evaluation of hemodynamic and SpO2 variability during different stages of periodontal surgery

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    Babak Amoian

    2013-01-01

    Full Text Available Background: Changes in pulse rate and blood pressure are common consequences during oral surgeries. Hypoxia during surgical process is another side effect. The objective of the present study was evaluation of blood hemoglobin oxygenation and hemodynamic changes during periodontal surgery. Materials and Methods: This clinical trial study was conducted upon 50 subjects aged 30-55 years who referred to the clinic of dental faculty of Babol University and needed periodontal surgery with modified widman flaps in the anterior section of the maxilla. Pulse rate, blood pressure, and pulse oximetric evaluations were recorded in five stages during surgery. Results: The average of systolic and diastolic blood pressure had been in their maximum amount in the second stage of evaluation and minimum amounts were in the first one; while pulse rate changes were greatest in the second stage and lowest in the fifth stage. Analyzing the data revealed no significant difference in Blood Oxygen Saturation (SpO2 measurements in none of the stages evaluated. Conclusions: Blood pressure and heart rate increased significantly after the injection of anesthetic drug and in further phases they were decreased after the elimination of stimulating effect of adrenaline. SpO 2 changes were not significantly prominent.

  16. Observation on the adverse reactions of different concentrations of povidone-iodine applied before cataract surgery

    Directory of Open Access Journals (Sweden)

    Shan-Jun Wu

    2013-12-01

    Full Text Available AIM: To evaluate the efficiency and safety of 50g/L povidone-iodine solution in preventing postoperative endophthalmitis through comparing the incidence of postoperative endophthalmitis and adverse reactions after conjunctival sac washing with povidone-iodine of different concentrations.METHODS: Totally 500 cataract patients were divided into 50g/L povidone-iodine group and 25g/L povidone-iodine group. All the operated eyes were observed during and after surgery.The patients' subjective discomfort was inquired and their signs of eyes were recorded. RESULTS: The eye irritation of 50g/L povidone-iodine group was more significant than 25g/L povidone-iodine group. No significant difference in the corneal epithelial loss and endophthalmitis was observed between two groups.CONCLUSION:Conjunctival sac washing with 50g/L povidone-iodine is an effective and safe measure to prevent endophthalmitis after cataract surgery.

  17. Variation of cataract surgery costs in four different graded providers of China

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    Fang Jiahua

    2010-09-01

    Full Text Available Abstract Background China has the largest population of cataract patients in the world. However, the cataract surgery rate per million remains low in China. We carried out a survey on costs of cataract surgery from four different graded providers in China and analyzed differences in cost among these clinics. Methods 1,189 patients were recruited for the study in four eye clinics, located in two provinces, Guangdong province in southern China and Hubei province in central China. The average cost of each cataract surgery episode was calculated including cost of intraocular lens, cost of drugs and facility cost. We also collected information on reimbursement and disposable annual income of local residents. Results Mean total cost per cataract intervention of four different providers varied considerably, ranging from US$ 1,293 in Union Hospital to US$ 536 in Jingshan County Hospital. In all providers, except for Jingshan County Hospital, the cost exceeded annual disposable income of local rural residents. As to the proportion of patients with reimbursement, the figure for Union Hospital was only 36%, while for other three clinics it was more than 60%. There was a significant difference between mean reimbursement ratios, with the highest ratio in Zhongshan Ophthalmic Center being 71%. Conclusions Significant differences in costs of cataract surgery were found among the 4 different graded providers. A part of the cost was borne by patients. Proportion of patients with reimbursement and mean reimbursement ratios were higher in economically developed regions than in economically developing regions. Much more financial support should be directed into the rural New Cooperative Medical Scheme to raise the reimbursement ratio in rural China.

  18. Parent socialization effects in different cultures: significance of directive parenting.

    Science.gov (United States)

    Sorkhabi, Nadia

    2012-06-01

    In this article, the controversy of divergent findings in research on parental socialization effects in different cultures is addressed. Three explanations intended to address divergent findings of socialization effects in different cultures, as advanced by researchers who emphasize cultural differences, are discussed. These include cultural differences in socialization values and goals of parents, parental emotional and cognitive characteristics associated with parenting styles, and adolescents' interpretations or evaluations of their parents' parenting styles. The empirical evidence for and against each of these arguments is examined and an alternative paradigm for understanding and empirical study of developmental outcomes associated with parenting styles in different cultures is suggested. Baumrind's directive parenting style is presented as an alternative to the authoritarian parenting style in understanding the positive developmental effects associated with "strict" parenting in cultures said to have a collectivist orientation. Directions for research on the three explanations are mentioned.

  19. Evaluation of 3 different registration techniques in image-guided bimaxillary surgery.

    Science.gov (United States)

    Sun, Yi; Luebbers, Heinz-Theo; Agbaje, Jimoh Olubanwo; Schepers, Serge; Vrielinck, Luc; Lambrichts, Ivo; Politis, Constantinus

    2013-07-01

    Perioperative navigation is an upcoming tool in orthognathic surgery. This study aimed to access the feasibility of the technique and to evaluate the success rate of 3 different registration methods--facial surface registration, anatomic landmark-based registration, and template-based registration. The BrainLab navigation system (BrainLab AG, Feldkirchen, Germany) was used as an additional precision tool for 85 patients who underwent bimaxillary orthognathic surgery from February 2010 to June 2012. Eighteen cases of facial surface-based registration, 63 cases of anatomic landmark-based registration, and 8 cases of template-based registration were analyzed. The overall success rate of facial surface-based registration was 39%, which was significant lower than template-based (100%, P = 0.013) and anatomic landmark-based registration (95%, P bimaxillary orthognathic surgery has been proved to be feasible. The registration process is the critical point regarding success of intraoperative navigation. Anatomic landmark-based registration is a reliable technique for image-guided bimaxillary surgery. In contrast, facial surface-based registration is highly unreliable.

  20. Evaluation of significant pigmets in green teas of different origin

    Directory of Open Access Journals (Sweden)

    Martina Ošťádalová

    2014-07-01

    Full Text Available This work monitors flavonoid pigments (theaflavins and thearubigins, and chlorophyll in green teas from different growing regions (India, China, Russia, Vietnam. These pigments affect the quality of the finished tea infusion and their quantity is affected by the way of tea processing (fermentation. 15 samples of green loose teas were selected for the analysis. The content of these pigments was determined using UV-Vis spectrophotometry, the concentration of flavonoid pigments was measured at a wavelength of 665 nm (theaflavins and 825 nm (thearubigins. Concentration of flavonoid pigments was determined using the standard conversion coefficients, which are 38.7 for TRs and 1.4 for TFs. Chlorophyll concentration was measured at 642.5 and 660 nm. Chlorophyll concentration was determined by the conversion using international standard conversion coefficients and calculation of linear regressions. The results were statistically processed and evaluated in the program of UNISTAT version 5.6. The total amount of chlorophyll ranged from 0.20 to 1.33 mg/L of tea. Concentrations of theaflavin ranged from 0.15 to 0.66 g/100 g of tea and TRs from 2.00 to 11.15 g/100 g of tea. The results showed that the amount of theaflavins, thearubigins and chlorophyll in green teas varied (P <0,05, especially in teas from lowlands in Vietnam and Krasnodar (Russia. Statistically demonstrable difference (P <0,05 in the content of pigments was also recorded in a group of Indian teas (from lowlands and, from a group of Chinese teas, a statistical difference (P <0,05 was demonstrated in the content of pigments in the mountain teas. On the basis of the results it can be concluded that the quality of green tea is mainly influenced by the processing method depending on the processing area (the factory, than by their country of origin.

  1. Inter-individual differences in cytokine release in patients undergoing cardiac surgery with cardiopulmonary bypass

    Science.gov (United States)

    Roth-Isigkeit, A; Hasselbach, L; Ocklitz, E; Brückner, S; Ros, A; Gehring, H; Schmucker, P; Rink, L; Seyfarth, M

    2001-01-01

    Cardiac surgery with cardiopulmonary bypass (CPB) leads to a systemic inflammatory response with secretion of cytokines (e.g. IL-6, TNF-α, IL-1β and sIL-2R). The objective of the following study was to investigate in vitro and in vivo cytokine responses and white blood cell counts (WBC) of patients with high versus low cytokine secretion after a coronary artery bypass grafting (CABG) procedure. Twenty male patients undergoing elective CABG surgery with CPB under general anaesthesia were enrolled in the study. On the day of surgery (postoperatively), serum levels of TNF-α and IL-1β were significantly higher in patients of the high IL-6 level group compared to the respective values in the patient group with low IL-6 levels. The inter-individual differences in IL-6 release in patients undergoing CABG surgery with CPB were accompanied by differences in the release of other cytokines, such as TNF-α, IL-1β and sIL-2R. To understand whether genetic background plays a role in influencing cytokine plasma levels under surgical stress, we examined the distribution of polymorphic elements within the promoter regions of the TNF-α and IL-6 genes, and determined their genotype regarding the BAT2 gene and TNF-β intron polymorphisms. Our preliminary data suggests that regulatory polymorphisms in or near the TNF locus, more precisely the allele set 140/150 of the BAT2 microsatellite marker combined with the G allele at −308 of the TNF-α gene, could be one of the genetic constructions providing for a less sensitive response to various stimuli. Our results suggest: (1) close relationships between cytokine release in the postoperative period, and (2) inter-individually varying patterns of cytokine release in patients undergoing CABG surgery with CPB. PMID:11472429

  2. Significant Differences in Nurses’ Knowledge of Basic Wound Management

    DEFF Research Database (Denmark)

    Zarchi, Kian; Latif, Seemab; Haugaard, Vibeke B

    2014-01-01

    Wounds represent a growing healthcare problem due to an aging population. Nurses play a key role in wound management and their theoretical understanding of basic wound management may be expected to influence the quality of wound therapy fundamentally. In this study, we evaluated the level...... of knowledge of wound management in 136 Danish nurses working in 3 different settings: advanced wound care clinics, home care and general hospital departments. We found that hospital nurses had less theoretical knowledge than home care nurses and nurses working at advanced wound care clinics. We also found...... that the length of experience (adjusted for workplace and education) did not have any impact on nurses' knowledge. Nurses' knowledge of clinical investigations was consistently lower than their knowledge of therapy and clinical symptoms. This study provides benchmarking information about the current status...

  3. Comparison of Two Different Doses of Intrathecal Levobupivacaine for Transurethral Endoscopic Surgery

    Science.gov (United States)

    Dizman, Secil; Turker, Gurkan; Gurbet, Alp; Mogol, Elif Basagan; Turkcan, Suat; Karakuzu, Ziyaatin

    2011-01-01

    Objective: To evaluate the effects of two different spinal isobaric levobupivacaine doses on spinal anesthesia characteristics and to find the minimum effective dose for surgery in patients undergoing transurethral resection (TUR) surgery. Materials and Methods: Fifty male patients undergoing TUR surgery were included in the study and were randomized into two equal groups: Group LB10 (n=25): 10 mg 0.5% isobaric levobupivacaine (2 ml) and Group LB15 (n=25): 15 mg 0.75% isobaric levobupivacaine (2 ml). Spinal anesthesia was administered via a 25G Quincke spinal needle through the L3–4 intervertebral space. Sensorial block levels were evaluated using the ‘pin-prick test’, and motor block levels were evaluated using the ‘Bromage scale’. The sensorial and motor block characteristics of patients during intraoperative and postoperative periods and recovery time from spinal anesthesia were evaluated. Results: In three cases in the Group LB10, sensorial block did not reach the T10 level. Complete motor block (Bromage=3) did not occur in eight cases in the Group LB10 and in five cases in the Group LB15. The highest sensorial dermatomal level detected was higher in Group LB15. In Group LB15, sensorial block initial time and the time of complete motor block occurrence were significantly shorter than Group LB10. Hypotension was observed in one case in Group LB15. No significant difference between groups was detected in two segments of regression times: the time to S2 regression and complete sensorial block regression time. Complete motor block regression time was significantly longer in Group LB15 than in Group LB10 (p<0.01). Conclusion: Our findings showed that the minimum effective spinal isobaric levobupivacaine dose was 10 mg for TUR surgery. PMID:25610173

  4. Are there significant interhemispherical differences in the surface solar spectrum?

    Science.gov (United States)

    Cordero, Raul; Damiani, Alessandro; Seckmeyer, Gunther; Rowe, Penny

    2017-04-01

    We compare ground-based measurements of the spectral irradiance (from the ultraviolet to the near infrared) carried out under cloudless conditions in Antofagasta (Chile, 23°S), on the Chajnantor Plateau (Atacama Desert, 23°S), at the Izaña Observatory (Tenerife, Spain, 28°N), in Hannover (Germany, 52°N), in Santiago (Chile, 33°S), on King George Island (Antarctic Peninsula 62°S) and at Union Glacier Camp Antarctica, 79°S). We show that the relatively low values in the ozone column in the southern hemisphere, lead peak ultraviolet levels in the Atacama Desert to be 50% higher than those observed in Tenerife. Differences in the visible and in the infrared ranges are less impressive but confirm that the world's highest irradiance (from the ultraviolet to the near infrared) occurs in the Atacama Desert. This area is characterized by its high altitude, prevalent cloudless conditions and relatively low columns of water vapor and ozone.

  5. Prognostic significance of γ-H2AX in laryngeal squamous cell carcinoma after surgery

    Institute of Scientific and Technical Information of China (English)

    Zhang Jingyi; Cheng Lei; Zhou Liang

    2014-01-01

    Background The clinical significance of γ-H2AX in laryngeal squamous cell carcinoma (LSCC) has not yet been established.This study was performed to assess the expression of nuclear γ-H2AX in benign and malignant laryngeal lesions and to assess its clinicopathological significance.Methods A total of 70 LSCC tumor-normal tissue paired samples were evaluated for γ-H2AX expression using immunohistochemical staining.Their expression was correlated with different clinicopathological parameters.Results Nuclear γ-H2AX expression was frequently detected in LSCC tissues (P <0.001).High nuclear γ-H2AX levels were not associated with any clinicopathological characteristics of LSCC (P >0.05).Univariate Kaplan-Meier analysis showed that positive nuclear γ-H2AX expression was associated with a decreased overall survival (P=0.017).Multivariate Cox regression analysis showed that nuclear γ-H2AX expression was an independent risk factor for overall survival.Conclusion The expression of nuclear γ-H2AX might be closely related to the prognosis of LSCC.

  6. A Comparison of Three Different Thick Epinucleus Removal Techniques in Cataract Surgery.

    Science.gov (United States)

    Hwang, Ho Sik; Lim, Byung-Su; Kim, Man Soo; Kim, Eun Chul

    2017-01-01

    To compare the outcomes of cataract surgery performed with three different types of the epinucleus removal techniques (safe boat, infusion/aspiration (I/A) cannulas, and phacoemulsification tip). Ninety eyes with thick adhesive epinuclei were randomly subdivided into three groups according to epinucleus removal technique: epinucleus floating (safe boat) technique, 30 patients; I/A tip, 30 patients; and phaco tip, 30 patients. Intraoperative measurements included ultrasound time (UST), mean cumulative dissipated ultrasound energy (CDE), and balanced salt solution (BSS) use. Clinical measurements were made preoperatively, and at one day, one month and two months postoperatively, including the best corrected visual acuity (BCVA), the central corneal thickness (CCT), and the endothelial cell count (ECC). Intraoperative measurements showed significantly less UST, CDE, and BSS use in the safe boat group than in the phaco tip groups (p phaco tip groups at two months post-cataract surgery (p phaco tip techniques in cases with thick epinucleus.

  7. Different models of training and certification in plastic surgery

    NARCIS (Netherlands)

    Fodor, L.; Ciuce, C.; Fodor, M.; Shrank, C.; Lapid, O.; Kon, M.; Ramon, Y.; Ullmann, Y.

    2009-01-01

    A varying period of training followed by examinations is the usual way to become a specialist in one of the many fields of Medicine. Plastic Surgery is one of the surgical fields that require good technical and cognitive skills. The best way to train and evaluate a candidate is hard to judge. The mo

  8. Anatomy, classification of intersinus septal cell and its clinical significance in frontal sinus endoscopic surgery in Chinese subjects

    Institute of Scientific and Technical Information of China (English)

    WANG Min; YUAN Fei; QI Wei-wei; CHENG Jye-yuan; YUAN Xiao-pei; HAN Lin; XING Zhi-min

    2012-01-01

    Background Intersinus septal cell (ISSC) is not a very uncommon frontal recess cell.But it is poorly described in literature.The clinical significance of this anatomic variant still remains unclear.The purpose of this study was to clarify the anatomy,classification of ISSC and its clinical significance in Chinese subjects.Methods We prospectively identified ISSC in 200 consecutive subjects who had undergone computed tomography (CT) scans:120 without frontal sinusitis (group 1) and 80 with frontal sinusitis (group 2).The ISSC was classified into two types:Type I ISSC communicated with frontal sinuses,type Ⅱ ISSC communicated with frontal recess.The patients of frontal sinusitis had undergone functional endoscopic sinus surgery with the assistance of the classification of ISSC.Statistical analysis was performed to correlate the ISSC and its type to the presence of frontal sinusitis.Results The ISSC was obvious when reviewing the coronal and axial CT scans.Of the 200 CT scans reviewed,ISSC were present in 90 (45%).Of the 120 scans in group 1,ISSC were present in 49 (41%),among which type I ISSC was in 22 (18%) and type Ⅱ was in 27 (23%).Of the 80 scans in group 2,ISSC was present in 41 (51%),among which type Ⅰ ISSC was in 16 (20%) and type Ⅱ was in 25 (31%).There were no statistically significant differences about the frequency distribution of total ISSC,type Ⅰ and Ⅱ ISSC between group 1 and group 2.Conclusions The prevalence of ISSC was very high in Chinese patients.The classification of ISSC was helpful for surgeon to operate according to whether it communicated with frontal sinus or frontal recess.The type Ⅱ ISSC could be relatively easily removed from frontal recess.

  9. Comparison of different methods involved in the planning of clinical crown lengthening surgery.

    Science.gov (United States)

    Zanatta, Fabricio Batistin; Giacomelli, Bruno Rodrigues; Dotto, Patricia Pasquali; Fontanella, Vânia Regina Camargo; Rosing, Cassiano Kuchenbecker

    2010-01-01

    There is little material in the literature that compares biological width measurements in periapical and bite-wings radiographs with clinical measurements. The purpose of this study was to compare measurements of biological width taken by three different methods which are frequently used for planning periodontal surgery - periapical radiograph, bite-wing radiograph and transperiodontal probing - with the trans-surgical measurements. Thirty-four sites from twenty-one subjects were analyzed. The intra-class correlation coefficients between measurements obtained trans-surgically (gold standard) and those obtained by transperiodontal probing, periapical radiography and bite-wing radiography were determined. Average measurements were compared using the Wilcoxon test at a significance level of 0.05. Also, the frequency distribution of differences between test measurements and the gold standard was calculated. The results showed that transperiodontal probing (mean 2.05 mm) was the most accurate measurement, as compared to the gold standard (mean 1.97 mm), with no statistically significant difference observed. On the other hand, periapical and bite-wing radiographic mean values (1.56 mm and 1.72 mm, respectively) were smaller than the gold standard, with statistically significant differences (p crown lengthening surgery should, preferably, include transperiodontal probing.

  10. Comparison of different methods involved in the planning of clinical crown lengthening surgery

    Directory of Open Access Journals (Sweden)

    Fabricio Batistin Zanatta

    2010-12-01

    Full Text Available There is little material in the literature that compares biological width measurements in periapical and bite-wings radiographs with clinical measurements. The purpose of this study was to compare measurements of biological width taken by three different methods which are frequently used for planning periodontal surgery - periapical radiograph, bite-wing radiograph and transperiodontal probing - with the trans-surgical measurements. Thirty-four sites from twenty-one subjects were analyzed. The intra-class correlation coefficients between measurements obtained trans-surgically (gold standard and those obtained by transperiodontal probing, periapical radiography and bite-wing radiography were determined. Average measurements were compared using the Wilcoxon test at a significance level of 0.05. Also, the frequency distribution of differences between test measurements and the gold standard was calculated. The results showed that transperiodontal probing (mean 2.05 mm was the most accurate measurement, as compared to the gold standard (mean 1.97 mm, with no statistically significant difference observed. On the other hand, periapical and bite-wing radiographic mean values (1.56 mm and 1.72 mm, respectively were smaller than the gold standard, with statistically significant differences (p < 0.05. It was concluded that transperiodontal probing was the most accurate measurement, as compared to the gold standard, followed by that obtained with the bite-wing radiograph. The clinical relevance of these results could be that planning for crown lengthening surgery should, preferably, include transperiodontal probing.

  11. [Patient satisfaction in ambulatory cataract surgery : Differences between outpatients in a special surgery or in a hospital].

    Science.gov (United States)

    Stein, I; Schoenfelder, T; Kugler, J

    2017-01-03

    The evaluation of patient satisfaction provides important information about subjective quality indicators from the patient's perspective. In Germany, cataract surgery is mostly done ambulatory in a special surgery or in a hospital. This study examines if there are differences in global patient satisfaction of either outpatient setting and if there are different determinants of global satisfaction with regard to the outpatient settings. The survey comprises ambulatory operated cataract patients in Saxony between 2014 and 2015. A total of 4800 cataract patients sent back a standardized, written questionnaire. Regression analysis identified determinants of global patient satisfaction in both groups. The most influencing parameters for the global satisfaction were satisfaction with the treatment outcome, atmosphere and facilities in the surgery or hospital as well as the staff's level of kindness. Results of the conducted study show most identified determinants of patient satisfaction are associated with service variables, such as atmosphere and facilities in surgery or hospital and waiting time in surgery or hospital. These aspects should be focused on to improve patient satisfaction in cataract patients.

  12. [Cervical epidural anesthesia for upper extremity surgery using three different formulations of local anesthetics].

    Science.gov (United States)

    Guevara-López, Uriah; Bárcenas-Olivares, Juan; Gutiérrez-Sougarret, Bernardo; Aldrete, J Antonio; Olascoaga-Ortega, Gabriela

    2005-01-01

    To evaluate the efficiency and safety of the cervical epidural blockade (CEB) in upper extremity surgery, using lidocaine 2%, bupivacaine 5% and a mixture of both local analgesics. Eighty five patients were submitted to upper limb surgery under CEB. They were assigned into one of three groups: group I received 100 mg of 2% lidocaine; group II received 30 mg of 0.5% bupivacaine, and group III received a mixture of 60 mg of 2% lidocaine and 15 mg of 0.5% bupivacaine. We evaluated their effects on vital signs, blockade quality, adverse effects, and patient comfort. Anesthesiologist and surgeon evaluated the technique as "good" in 80% of the patients. Significant differences were found for motor blockade. Group II developed complete motor block (100%). Observed adverse effects were vomiting in groups II and III and dural puncture was present in 6.7% of the cases in group II. This study confirms the safety of cervical epidural anesthesia for upper limb surgery using three different formulations of local anesthetics.

  13. The effects of different oxygen concentrations on recruitment maneuver during general anesthesia for laparoscopic surgery.

    Science.gov (United States)

    Topuz, Ufuk; Salihoglu, Ziya; Gokay, Banu V; Umutoglu, Tarik; Bakan, Mefkur; Idin, Kadir

    2014-10-01

    Recruitment maneuvers (RMs), which aim to ventilate the collaborated alveolus by temporarily increasing the transpulmonary pressure, have positive effects in relation to respiration, mainly oxygenation. Although many studies have defined the pressure values used during RM and the application period, our knowledge of the effects of different oxygen concentrations is limited. In this study, we aimed to determine the effects of different oxygen concentrations during RM on the arterial oxygenation and respiration mechanics in laparoscopic cases. Thirty-two patients undergoing laparoscopic cholecystectomy were recruited into the study. The patients were randomly divided into 2 groups. RM with a 30% oxygen concentration was performed in patients within the first group (group I, n=16), whereas patients in the second group (group II, n=16) received RM with 100% oxygen. To study respiratory mechanics, dynamic compliance (Cdyn), airway resistance (Raw), and peak inspiratory pressure were measured at 3 different times: 5 minutes after anesthesia induction, 5 minutes after the abdomen was insufflated, and 5 minutes after the abdomen was desufflated. Arterial blood gases were measured during surgery and 30 minutes after surgery (postoperative). The average postoperative partial arterial oxygen pressure values of the patients in groups I and II were 121 and 98 mm Hg, respectively. The difference between the groups was statistically significant. In addition, the decrease in compliance from induction values after desufflation in group II was statistically significant. On the basis of our results, maintaining oxygen concentrations below 100% during RM may be more beneficial in terms of respiratory mechanics and gas exchange.

  14. Prevention and Treatment of Shivering after Intracranial Surgery Using Different Dosages of Tramadol

    Institute of Scientific and Technical Information of China (English)

    Yu-hua Qi; Guo-nian Wang; Shu-yan Wang

    2005-01-01

    @@ During the anesthesia recovery period, shivering is a common uncomfortable complaint of patients increasing oxygen consumption, carbon dioxide production, intraocular and intracranial pressures, all disadvantage for intracranial tumor surgery. The aim of our study is to observe the effect of different dosages of tramadol in the prevention and treatment of shivering after intracranial surgery.

  15. Sympathetic ophthalmitis following vitreoretinal surgery: Does antecedent trauma make a difference?

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    Ekta Rishi

    2015-01-01

    Full Text Available Background: Sympathetic ophthalmitis (SO has been reported following vitrectomy; however, there is a lack of data on the role of antecedent penetrating ocular trauma impacting the disease manifestation in eyes developing SO following vitrectomy. Aim: To report differences in the presentation and outcomes of SO in eyes with or without a history of antecedent penetrating trauma; SO being diagnosed after vitreoretinal (VR surgery. Design: Comparative case series. Methods: Seventeen consecutive patients presenting with SO following VR surgery, diagnosed between 1995 and 2011 were included. Eyes with and without prior penetrating injury were included in Group I (n = 7 and Group II (n = 10, respectively. All Group I patients had received systemic steroids prior to presentation. Demographic and clinical parameters were evaluated. Results: Differences were observed between Group I and Group II mainly with regards to time interval between VR surgery and diagnosis of SO (1.5 months vs. 8 months, P = 0.10, presence of neurosensory detachments (100% vs. 30%, P = 0.01, and the inciting eye vision at presentation (nil light perception in 28.5% vs. 80%, P = 0.049. Other differences observed though not statistically significant were optic disc and retinal vessel involvement (42% vs. 70%, P = 0.28, Dalen-Fuchs nodules (localized vs. diffuse and leaks on fundus fluorescein angiography (pin-head vs. pin-point leak. Conclusion: SO in patients with antecedent penetrating ocular trauma present early with the central serous chorioretinopathy-like picture. Prior use of systemic steroids might have a bearing on the differences in presentation and the visual acuities between the two groups.

  16. Mandibular advancement surgery in high-angle and low-angle class II patients: different long-term skeletal responses.

    Science.gov (United States)

    Mobarak, K A; Espeland, L; Krogstad, O; Lyberg, T

    2001-04-01

    The objective of this cephalometric study was to compare skeletal stability and the time course of postoperative changes in high-angle and low-angle Class II patients after mandibular advancement surgery. The subjects were 61 consecutive mandibular retrognathism patients whose treatment included bilateral sagittal split osteotomy and rigid fixation. The patients were divided according to the preoperative mandibular plane angle; the 20 patients with the lowest mandibular plane angle (20.8 degrees +/- 4.9 degrees ) constituted the low-angle group, while the 20 cases with the highest mandibular plane angle (43.0 degrees +/- 4.0 degrees ) represented the high-angle group. Lateral cephalograms were taken on 6 occasions: immediately before surgery, immediately after surgery, 2 and 6 months after surgery, and 1 and 3 years after surgery. Results demonstrated that the high-angle and low-angle groups had different patterns of surgical and postoperative changes. High-angle patients were associated with both a higher frequency and a greater magnitude of horizontal relapse. While 95% of the total relapse took place during the first 2 months after surgery in the low-angle group, high-angle patients demonstrated a more continuous relapse pattern, with a significant proportion (38%) occurring late in the follow-up period. Possible reasons for the different postsurgical response are discussed.

  17. Acute hypothalamic suppression significantly affects trabecular bone but not cortical bone following recovery and ovariectomy surgery in a rat model

    Directory of Open Access Journals (Sweden)

    Vanessa R. Yingling

    2016-01-01

    RH-a group compared to C, a similar deficit in BV/TV was also measured following recovery and post-OVX. The trabecular number and thickness were lower in the GnRH-a group compared to control.Conclusion. These data suggest that following a transient delay in pubertal onset, trabecular bone volume was significantly lower and no restoration of bone volume occurred following recovery or post-OVX surgery. However, cortical bone strength was maintained through architectural adaptations in the cortical bone envelope. An increase in the polar moment of inertia offset increased bone resorption. The current data are the first to suppress trabecular bone during growth, and then add an OVX protocol at maturity. Trabecular bone and cortical bone differed in their response to hypothalamic suppression during development; trabecular bone was more sensitive to the negative effects of hypothalamic suppression.

  18. Dedicated Research Time During Surgery Residency Leads to a Significant Decline In Self-Assessed Clinical Aptitude and Surgical Skills.

    Science.gov (United States)

    Grova, Monica M; Yang, Anthony D; Humphries, Misty D; Galante, Joseph M; Salcedo, Edgardo S

    2017-05-19

    The surgical community commonly perceives a decline in surgical and patient care skills among residents who take dedicated time away from clinical activity to engage in research. We hypothesize that residents perceive a decline in their skills because of dedicated research time. UC Davis Medical Center, Sacramento, CA, an institutional tertiary care center. General surgery residents and graduates from UC Davis general surgery residency training program, who had completed at least 1 year of research during their training. A total of 35 people were asked to complete the survey, and 19 people submitted a completed survey. Participants were invited to complete an online survey. Factors associated with the decline in skills following their research years were examined. All statistical analyses were performed with IBM SPSS Statistics software. A total of 19 current or former general surgery residents responded to the survey (54% response rate). Overall, 42% described their research as "basic science." Thirteen residents (68%) dedicated 1 year to research, while the remainder spent 2 or more years. Basic science researchers were significantly more likely to report a decrease in clinical judgment (75% vs. 22%, p = 0.013) as well as a decrease in patient care skills (63% vs. 0%, p = 0.002). Residents who dedicated at least 2 years to research were more likely to perceive a decline in overall aptitude and surgical skills (100% vs. 46%, p = 0.02), and a decline in patient care skills (67% vs. 8%, p = 0.007). Most residents who dedicate time for research perceive a decline in their overall clinical aptitude and surgical skills. This can have a dramatic effect on the confidence of these residents in caring for patients and leading a care team once they re-enter clinical training. Residents who engaged in 2 or more years of research were significantly more likely to perceive these problems. Further research should determine how to keep residents who are interested in academics

  19. Gender differences in the learning and teaching of surgery: a literature review

    Science.gov (United States)

    Josephson, Anna

    2014-01-01

    Objectives To explore evidence concerning gender differences in teaching and learning in surgery to guide future initiatives. Methods This systematic review was conducted searching in the following electronic databases: MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Web of Science, Scopus and PubMed. All studies related to gender differences in surgical education, teaching or learning of surgery at an undergraduate level were included. Data was extracted and critically appraised. Gender differences in learning, teaching, skills acquisition, perceptions and attitudes, interest on surgery, personality and factors influencing interest in surgical careers were differentiated. Results There is an underrepresentation of women in surgical academia, due to lack of role models and gender awareness. It is not clear whether or not gender itself is a factor that affects the learning of surgical tasks. Female students pursuing a surgical career had experienced sexual harassment and gender discrimination that can have an effect on the professional identity formation and specialty choice. There are differences in personality among female and male students interested in surgery. Gender is a determining factor to choose surgery, with a consistent lower proportion of women compared interested in pursuing a surgical career. Mentoring and personality fit are important in medical student’s specialty selection. Female students are more likely to be discouraged from pursuing a surgical career by a lack of female role models. Conclusions Bias against women in surgery still exists. There is a lack of studies that investigate the role of women in the teaching of surgery. PMID:25341220

  20. Gender differences in the learning and teaching of surgery: a literature review.

    Science.gov (United States)

    Burgos, Carmen M; Josephson, Anna

    2014-06-15

    To explore evidence concerning gender differences in teaching and learning in surgery to guide future initiatives. This systematic review was conducted searching in the following electronic databases: MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Web of Science, Scopus and PubMed. All studies related to gender differences in surgical education, teaching or learning of surgery at an undergraduate level were included. Data was extracted and critically appraised. Gender differences in learning, teaching, skills acquisition, perceptions and attitudes, interest on surgery, personality and factors influencing interest in surgical careers were differentiated. There is an underrepresentation of women in surgical academia, due to lack of role models and gender awareness. It is not clear whether or not gender itself is a factor that affects the learning of surgical tasks. Female students pursuing a surgical career had experienced sexual harassment and gender discrimination that can have an effect on the professional identity formation and specialty choice. There are differences in personality among female and male students interested in surgery. Gender is a determining factor to choose surgery, with a consistent lower proportion of women compared interested in pursuing a surgical career. Mentoring and personality fit are important in medical student's specialty selection. Female students are more likely to be discouraged from pursuing a surgical career by a lack of female role models. Bias against women in surgery still exists. There is a lack of studies that investigate the role of women in the teaching of surgery.

  1. Effects of different general anaesthetic techniques on immune responses in patients undergoing surgery for tongue cancer.

    Science.gov (United States)

    Zhang, T; Fan, Y; Liu, K; Wang, Y

    2014-03-01

    The aim of this study was to investigate the effects of different general anaesthesia techniques on immune responses in patients undergoing surgery for tongue cancer. Sixty American Society of Anesthesiologists physical status 1 or 2 patients undergoing elective reconstructive surgery for tongue cancer were randomised to three groups. Group 1 received propofol induction and maintenance (TIVA), group 2 received propofol induction and sevoflurane maintenance (MIXED) and group 3 received sevoflurane induction and maintenance (SEVO). All patients received an infusion of remifentanil. Blood samples were obtained at eight time-points: 30 minutes before induction (T0); one hour (T1), three hours (T2) and five hours (T3) after induction; at the end of the operation (T4); and 24 hours (T5), 48 hours (T6) and 72 hours (T7) after operation. The T lymphocyte subsets (including CD3(+) cells, CD3(+)CD4(+) cells and CD3(+)CD8(+)cells) and CD4(+)/CD8(+) ratio, natural killer cells and B lymphocytes were analysed by flow cytometry. All immunological indicators except CD3(+)CD8(+) cells were significantly decreased in all groups at T1~T5 compared to T0 (P <0.05). The percentages of CD3(+) cells, CD3(+)CD4(+) cells and natural killer cells, and the CD4(+)/CD8(+) ratios were significantly lower in the MIXED groups and SEVO groups but not the TIVA group at T6 as compared with T0 (P <0.05). There were minor but statistically significant differences in the percentages of CD3(+) cells, CD3(+)CD4(+) cells and natural killer cells, and the CD4(+)/CD8(+) ratios between the SEVO group and the TIVA group at T2approxT6 (P <0.05). These findings suggest that propofol has slightly less effect on cellular immune responses than sevoflurane.

  2. A study of patient satisfaction after cataract surgery with implantation of different types of intraocular lenses

    Directory of Open Access Journals (Sweden)

    Wei Ching-Kuo

    2012-10-01

    Full Text Available Abstract Background The implementation of capitated payment has driven medical institutions through developing balance billing for medical services. By exploring the patients’ decision-making factors on different self-pay items, a reference for the pricing and sales strategy for the related products can be formed. The major purposes of this study were to analyze the determinants of preoperative selection and postoperative satisfaction with implantation of different types of intraocular lenses in cataract surgery. Methods This cross-sectional study consisted of 127 patients that were 50 years of age and older, and who had phacoemulsification with intraocular lens implantation in both eyes. Data were collected by using a structured questionnaire. The following parameters were measured: access to medical care, attitude towards receiving medical products at one’s own expense, overall patient satisfaction and postoperative visual clarity. Results The results showed that the patient’s gender, educational level and economic status influenced the type of intraocular lens chosen. Patients in the insurance group cared about access to medical care, and patients in the balance billing group cared about product differentiation. ANOVA results showed no statistically significant differences in the overall satisfaction of the patients among the groups with different types of intraocular lenses. Patients that received cataract surgery with implantation of multifocal intraocular lenses had better vision when trying to view smaller objects and when looking at objects under strong light. Conclusions Manufacturers should increase the number of differences between their products, and health care providers can then recommend the appropriate intraocular lens in accordance with the needs or demands of their patients, and also by keeping in mind the financial constraints of their patients.

  3. Clinical effects of conjunctival sac flushing using different concentration of povidoneiodine on corneal epithelium before cataract surgeries

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    Xue-Lian Gu

    2015-10-01

    Full Text Available AIM:To determine the most optimal concentration of the safe usage of povidone-iodine(PVP-Iin the flushing to disinfect the conjunctive sac before cataract surgeries, in order to provide a scientific basis for clinical eye surgery work.METHODS:Sixty-two patients with phacoemulsification and intraocular lens implantation in our hospital from October 2012 to October 2014 were randomly divided into 0.25g/L PVP-I group(Ⅰand 5g/L PVP-I group(Ⅱ. Sterilizing effect and the complications postoperative were analyzed.RESULTS:The sterilizing effects of the two groups after flushing conjunctiva sac using different concentrations of PVP-I were both remarkable, but the difference between the two groups was not statistically significant(P>0.05. No endophthalmitis occurred in the two groups. Observing the corneal condition after rinsing, no severe conjunctival hyperemia, corneal edema and other serious complications occurred. There was slightly punctate corneal epithelial shedding in groupⅡ, and the difference was statistically significant(PPCONCLUSION:Using 0.25g/L PVP-I in the conjunctiva sac rinsing before surgeries can inhibit the growth of bacteria in the conjunctival sac, reduce the impact on the corneal epithelium thereby reducing the incidence of postoperative complications and the positive rate of bacterial culture, increasing the comfort degree of patients, bringing a better area for the surgeries.

  4. Clinical evaluation of the centrifugal pump in open heart surgery: a comparative study of different pumps.

    Science.gov (United States)

    Takarabe, K; Yoshikai, M; Murayama, J; Hamada, M; Ito, T

    1997-07-01

    The centrifugal pump is now widely used in open heart surgery for its clinical benefits related to the blood elements and the coagulation system. The purpose of this study was to compare the clinical performances of and the outcomes offered by 4 types of centrifugal pumps. For each pump, we investigated the effects on the blood elements, coagulation system, complements, and immunoglobulins during open heart surgery. Four types of centrifugal pumps were used: the HPM-15 (Nikkiso Co.), the Capiox (Terumo Co.), the Lifestream (St. Jude Medical Co.), and the BP-80 (Medtronic, BioMedicus Co.). The platelet count, lactate dehydrogenase (LDH), antithrombin III (AT III), thrombin-antithrombin complex (TAT), complements (C3, C4, and CH50), and immunoglobulins (IgG, IgA, and IgM) were measured before and after cardiopulmonary bypass (CPB). The platelet count was decreased more significantly by the HPM-15 than by any of the other pumps. The other parameters showed no difference among the 4 pumps. In clinical use, each of the 4 types of centrifugal pumps was safe.

  5. Gender-specific differences in chronic rhinosinusitis patients electing endoscopic sinus surgery.

    Science.gov (United States)

    Lal, Devyani; Rounds, Alexis B; Divekar, Rohit

    2016-03-01

    The objective of this study was to investigate gender-specific differences in chronic rhinosinusitis (CRS) patients electing endoscopic sinus surgery (ESS). This study was a retrospective review of CRS patients electing ESS (2011-2013) at a tertiary-care center. ESS was elected by 272 patients (mean age 54.6 years; 48.5% female). Mean Lund-Mackay computed tomography (CT) score was 10.9; total 22-item Sino-Nasal Outcome Test (SNOT-22) score was 41.8. Compared to men, women electing ESS had lower CT score (10.1 vs 11.7; p = 0.01) but higher total SNOT-22 score (44.9 vs 39; p = 0.02). Women reported significantly worse postnasal drainage (p embarrassment (p = 0.0021). SNOT-22 scores declined with advancing age (women, p = 0.003; men, p = 0.0005). Reduction in CT scores with age was seen only in males (p = 0.03). Stratifying by age, females aged 61 to 80 years had higher SNOT-22 scores compared to male counterparts (p = 0.04), whereas CT scores were similar. More women underwent surgery for CRS without nasal polyps (CRSsNP) (54.9%) whereas more men underwent surgery for CRS with nasal polyps (CRSwNP) (57.4%), but this difference missed statistical significance (p = 0.052). Women with CRSwNP had higher SNOT-22 scores than men (p = 0.02) for similar CT scores. Men electing ESS for CRSsNP had higher CT scores than women (p = 0.02). Women with CRSsNP aged 18 to 40 years reported higher SNOT-22 scores than men (p = 0.003), even though CT scores were lower (p = 0.005). Equivalent numbers of men and women underwent ESS for CRS. Overall, women electing ESS had higher total SNOT-22 scores and lower Lund-Mackay CT scores than men. Women reported more problems with postnasal drainage (CRS overall, CRSsNP, and CRSwNP), embarrassment (CRS overall and CRSwNP), and facial pain (CRSwNP). Gender differences in CRS are poorly understood and merit further study. © 2015 ARS-AAOA, LLC.

  6. Prognostic significance of the combined expression of neutral endopeptidase and dipeptidyl peptidase IV in intrahepatic cholangiocarcinoma patients after surgery resection

    Directory of Open Access Journals (Sweden)

    Zhu JY

    2014-02-01

    Full Text Available Jianyong Zhu,1,* XiaoDong Guo,2,* Baoan Qiu,1 Zhiyan Li,2 Nianxin Xia,1 Yingxiang Yang,1 Peng Liu1 1Department of Hepatobiliary Surgery, Navy General Hospital, PLA, Beijing, People's Republic of China; 2302 Hospital of PLA, Beijing, People's Republic of China *These authors contributed equally to this work Aim: The aim of this study was to investigate the relationship between the expression of neutral endopeptidase (NEP and dipeptidyl peptidase IV (DPP IV proteins, and the clinical significance of the two proteins in patients with intrahepatic cholangiocarcinomas (IHCC. Methods: Expression patterns and subcellular localizations of NEP and DPP IV proteins in 186 primary IHCC and 60 noncancerous liver tissue specimens were detected by immunohistochemistry. Results: Both the expression of NEP and DPP IV proteins in IHCC tissues were significantly higher than those in noncancerous liver tissues (both P<0.001. Of 186 patients with IHCC, 128 (68.82% highly expressed both NEP and DPP IV proteins. In addition, the coexpression of NEP and DPP IV proteins was significantly associated with advanced tumor stage (P=0.009, positive lymph node metastasis (P=0.016 and distant metastasis (P=0.013, and the presence of recurrence (P=0.027. Moreover, Kaplan–Meier analysis showed that IHCC patients with high NEP expression, high DPP IV expression, and combined overexpression of NEP and DPP IV proteins all had poorer overall survival and early recurrence after surgery. Furthermore, Cox analysis suggested that NEP expression, DPP IV expression, and combined expression of NEP and DPP IV proteins were all independent prognostic markers for overall survival and recurrence-free survival in patients with IHCC. Conclusion: Our data suggest, for the first time, that both the expression of NEP and DPP IV proteins may be upregulated in human IHCC tissues and the combined expression of NEP and DPP IV proteins may play important roles in progression and prognosis of patients

  7. QUALITY OF LIFE IN PATIENTS BEFORE AND AFTER LUMBAR SURGERY IN DIFFERENT WORK SITUATIONS

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    Bruno Vieira Motter

    2015-09-01

    Full Text Available Objective:To evaluate the quality of life of patients after spine surgery related to the return to work activities.Methods:Retrospective review of medical records of patients operated for degenerative spinal disease and application of questionnaire about quality of life (SF-36 in the preoperative and postoperative periods at one month, six months, one year and two years. Patients were divided into three groups: those who returned to work, who were away from work and retired patients. Then the statistical analysis was conducted and the evolution of quality of life was assessed according to the return to activity.Results:Evaluating patients for the variable return to activity, it was found statistically significant difference in the time for the variables: functional, physical, pain, vitality, social and mental. For patients who did not return to activity, the evolution was statistically significant for the variables: functional, physical, pain, vitality and social. For retired patients the outcome was statistically significant for all domains, except for "General".Conclusion:The quality of life has improved in all groups postoperatively, being observed more significant results in the group that returned to their work activities.

  8. Importance of Exercise Capacity in Predicting Outcomes and Determining Optimal Timing of Surgery in Significant Primary Mitral Regurgitation

    Science.gov (United States)

    Naji, Peyman; Griffin, Brian P.; Barr, Tyler; Asfahan, Fadi; Gillinov, A. Marc; Grimm, Richard A.; Rodriguez, L. Leonardo; Mihaljevic, Tomislav; Stewart, William J.; Desai, Milind Y.

    2014-01-01

    Background In primary mitral regurgitation (MR), exercise echocardiography aids in symptom evaluation and timing of mitral valve (MV) surgery. In patients with grade ≥3 primary MR undergoing exercise echocardiography followed by MV surgery, we sought to assess predictors of outcomes and whether delaying MV surgery adversely affects outcomes. Methods and Results We studied 576 consecutive such patients (aged 57±13 years, 70% men, excluding prior valve surgery and functional MR). Clinical, echocardiographic (MR, LVEF, indexed LV dimensions, RV systolic pressure) and exercise data (metabolic equivalents) were recorded. Composite events of death, MI, stroke, and congestive heart failure were recorded. Mean LVEF was 58±5%, indexed LV end‐systolic dimension was 1.7±0.5 mm/m2, rest RV systolic pressure was 32±13 mm Hg, peak‐stress RV systolic pressure was 47±17 mm Hg, and percentage of age‐ and gender‐predicted metabolic equivalents was 113±27. Median time between exercise and MV surgery was 3 months (MV surgery delayed ≥1 year in 28%). At 6.6±4 years, there were 53 events (no deaths at 30 days). On stepwise multivariable survival analysis, increasing age (hazard ratio of 1.07 [95% confidence interval, 1.03 to 1.12], P100% predicted metabolic equivalents (n=399), delaying surgery by ≥1 year (median of 28 months) did not adversely affect outcomes (P=0.8). Conclusion In patients with primary MR that underwent exercise echocardiography followed by MV surgery, lower achieved metabolic equivalents were associated with worse long‐term outcomes. In those with preserved exercise capacity, delaying MV surgery by ≥1 year did not adversely affect outcomes. PMID:25213567

  9. Cytologic subclassification of atypia of undetermined significance may predict thyroid nodules more likely to be malignant at surgery.

    Science.gov (United States)

    Shrestha, Rupendra T; Hennessey, James V

    2016-06-01

    The atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS) category in the Bethesda System of reporting thyroid fine-needle aspiration (FNA) includes various cytological findings considered to have a low risk of malignancy. It is still unclear if any particular subset of the cytological findings within this category carries a higher risk for malignancy requiring a more aggressive treatment plan. We reviewed 221 AUS/FLUS FNAs performed between January of 2006 and May of 2012. Histopathological data from surgery was available in 101 nodules and characteristics of these nodules were analyzed. We reviewed the initial cytology report and subclassified the nodules into one of four groups: architectural atypia (AA, includes abnormal follicular arrangement but no cellular abnormalities), cellular atypia (CA, atypical cellular findings) with or without AA, Hurthle cells Predominant and Others that included otherwise unspecified AUS categories. The surgical pathology confirmed malignancy rate for each group was calculated. Papillary thyroid carcinoma was the most common malignancy identified (26 of 29 or 90%). We found that in the AA only category, 2/21 (10%) nodules were malignant, whereas when CA with or without AA was present, 23/66 (35%) were malignant, significantly higher than the former group (P values of 0.025). CA seen on initial AUS/FLUS had a higher malignancy rate compared to AA group. Further research is required to consider subclassification of this category to assign appropriate risk of malignancy for AUS nodules. Diagn. Cytopathol. 2016;44:492-498. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  10. Prothrombotic SERPINC1 gene polymorphism may affect heparin sensitivity among different ethnicities of Chinese patients receiving heart surgery.

    Science.gov (United States)

    Wang, Jiang; Ma, Hai-Ping; Ti, Ai Lai Ti Ta Lai; Zhang, Yong-Qiang; Zheng, Hong

    2015-11-01

    The purpose of this study was to investigate a possible correlation between single-nucleotide polymorphisms (SNPs) of the antithrombin (gene, SERPINC1, and perioperative sensitivity to heparin in patients receiving heart surgery. The SERPINC1 genotype and allele frequency, coagulation parameters 24 hours before and after surgery, and clinical findings were compared among 3 ethnic groups, Han, Uighur, and Kazakh, patientswho received heart surgery. In Han patients, longer coagulation time as well as higher heparin and protamine dosage was observed. SERPINC1 gene sequencing identified 2 mutations in exon 5, g.981A>G (rs5877) and g.1011A>G (rs5878). The minor allele frequency of allele (A>G) for rs5877 and rs5878 was higher in the Han patients and was significantly different among the ethnic groups (P = .004 and P = .006, respectively). The increased SERPINC1 SNP frequency among Han patients receiving heart surgery might contribute to the differences in their perioperative sensitivity to heparin.

  11. Related research on corneal higher-order aberrations after different ways refractive surgery

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    Shu-Xi He

    2015-08-01

    Full Text Available AIM:To evaluate the changes of corneal high-order aberration(including Coma, Spab, RMShafter laser in situ keratomileusis(LASIKwith femtosecond laser, sub-Bowman keratomileusis(SBKand laser epithelial keratomileusis(LASEK.METHODS: Of 82 myopic patients(164 eyes, 31 patients(62 eyeswere treated by FS-LASIK, 31 patients(62 eyeswere treated by SBK, 20 patients(40 eyeswere treated by LASEK. Sirius system was used for measuring the coma aberration, spherical aberration, and high order aberration at 1, 15d,1, 3mo after surgery.RESULTS: 1Vision: The uncorrected visual acuity of the three groups had no differences(P>0.05. 2Corneal aberrations: Three kinds of surgical procedure for patients with corneal aberration had significant impact. The C7, C8, C12 and RMSh of three groups were increased significantly(P0.05. The C7, C8, C12 and RMSh were not recovered to preoperative levels after 3mo. But the increase of patients after FS-LASIK was smaller than the other two groups, with statistical significance(P0.05.CONCLUSION: Compared with SBK and LASEK,FS-LASIK has better visual acuity in the early postoperative and corneal higher-order aberrations increase is relatively small.

  12. Ambulatory orthopaedic surgery patients' emotions when using different patient education methods.

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    Heikkinen, Katja; Salanterä, Sanna; Leppänen, Tiina; Vahlberg, Tero; Leino-Kilpi, Helena

    2012-07-01

    A randomised controlled trial was used to evaluate elective ambulatory orthopaedic surgery patients' emotions during internet-based patient education or face-to-face education with a nurse. The internet-based patient education was designed for this study and patients used websites individually based on their needs. Patients in the control group participated individually in face-to-face patient education with a nurse in the ambulatory surgery unit. The theoretical basis for both types of education was the same. Ambulatory orthopaedic surgery patients scored their emotions rather low at intervals throughout the whole surgical process, though their scores also changed during the surgical process. Emotion scores did not decrease after patient education. No differences in patients' emotions were found to result from either of the two different patient education methods.

  13. Clinical significance of gastric outlet obstruction on the oncologic and surgical outcomes of radical surgery for carcinoma of the distal stomach.

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    Park, Seong-Heum; Mok, Young-Jae; Kim, Jong-Han; Park, Sung-Soo; Kim, Seung-Joo; Kim, Chong-Suk

    2009-09-01

    To determine the significance of gastric outlet obstruction (GOO) on the outcomes of radical surgery for distal gastric cancer. Three hundred seventy-one patients who underwent radical surgery for advanced gastric cancer arising at the distal stomach were categorized into two groups according to the presence of GOO, that is, 59 patients with GOO and 312 patients without. Clinicopathologic variables, postoperative morbidity and mortality, recurrence pattern, and survival outcomes of the two groups were compared. Distal gastric carcinoma with GOO was usually diagnosed at a more advanced stage with aggressive pathologic features. GOO adversely affected overall survival after radical surgery with an odds ratio of 2.068 (P gastric cancer and provide additional information for identifying patients at higher risk of recurrence and pattern of recurrence during follow-up. Radical surgery in patients with GOO can be performed with acceptable morbidity and mortality.

  14. Health-related quality of life is impaired in primary hyperparathyroidism and significantly improves after surgery: a prospective study using the 15D instrument.

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    Ryhänen, Eeva M; Heiskanen, Ilkka; Sintonen, Harri; Välimäki, Matti J; Roine, Risto P; Schalin-Jäntti, Camilla

    2015-09-01

    Health-related quality of life (HRQoL) is frequently impaired in primary hyperparathyroidism (PHPT) but it is unclear if surgery is beneficial. The objective was to prospectively assess HRQoL in PHPT (n=124) with the 15D instrument before and after surgery, to compare it with that of a comparable sample of the general population (n=4295), and search for predictors of HRQoL and its change. HRQoL, and clinical and laboratory parameters were measured before and at 6 and 12 months after surgery. Regression techniques were used to search for predictors of HRQoL and gains from treatment. Before surgery, PHPT patients had significantly lower mean 15D score compared to controls (0.813 vs 0.904, P<0.001). Excretion, mental function, discomfort and symptoms, distress, depression, vitality, and sexual activity were most impaired (all P<0.001). Number of medications (P=0.001) and subjective symptoms (P<0.05) but not calcium or parathyroid hormone (PTH) predicted impaired HRQoL. Serum 25-hydroxyvitamin D (25OHD) was of borderline significance (P=0.051). Compared to baseline, mean 15D score improved significantly 6 months after surgery (0.813 vs 0.865, P<0.001) and the effect sustained at 1 year (0.878, P<0.001). The improvement was clinically important in 77.4% of patients (P<0.001). Educational level independently predicted improvement (P<0.005). HRQoL is severely impaired in PHPT but improves significantly after surgery. The 15D is a sensitive tool for assessing HRQoL and recognizing patients likely to benefit from surgery.

  15. Do personality differences between teachers and learners impact students' evaluations of a surgery clerkship?

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    Bell, Mary Alice; Wales, Paula S; Torbeck, Laura J; Kunzer, John M; Thurston, Virginia C; Brokaw, James J

    2011-01-01

    Historically, the surgery clerkship at the Indiana University School of Medicine (IUSM) has received poor evaluations from medical students, and the authors of this article hypothesized that this negative feedback may reflect, at least in part, inherent differences in the personality styles of the learners compared with those of the surgery teachers (faculty and residents). Differences between teachers and learners could impede effective communication and impact adversely students' perception of, and satisfaction with, the learning environment. The objective of this study was to compare the inherent personality styles of surgery teachers and medical students. Using the Myers-Briggs Type Indicator (MBTI) to assess personality styles, we administered the instrument to 154 teachers in the surgery department and to 1395 medical students. Aggregate MBTI data for teachers and learners were analyzed based on four dichotomous scales. Chi square tests of independence were performed to examine the relationship between teachers and learners on the MBTI scales. The study was undertaken at IUSM, which has been engaged in a process of cultural change for over 10 years, in part to ensure that both the formal curriculum and the learning environment support the development of self-awareness and professionalism among our graduates. We found that teachers were similar to learners on the Introversion/Extraversion scale and dissimilar from learners on the three remaining scales: Sensing/Intuition scale (p personality styles may affect the teacher-learner interaction during the surgery clerkship and may influence negatively students' perception of the learning environment. Copyright © 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  16. Turbinate surgery

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    Turbinectomy; Turbinoplasty; Turbinate reduction; Nasal airway surgery; Nasal obstruction - turbinate surgery ... There are several types of turbinate surgery: Turbinectomy: All or ... This can be done in several different ways, but sometimes a ...

  17. Student perception of two different simulation techniques in oral and maxillofacial surgery undergraduate training

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    Sallnäs Eva-Lotta

    2011-10-01

    Full Text Available Abstract Background Yearly surveys among the undergraduate students in oral and maxillofacial surgery at Karolinska Institutet have conveyed a wish for increased clinical training, and in particular, in surgical removal of mandibular third molars. Due to lack of resources, this kind of clinical supervision has so far not been possible to implement. One possible solution to this problem might be to introduce simulation into the curriculum. The purpose of this study was to investigate undergraduate students' perception of two different simulation methods for practicing clinical reasoning skills and technical skills in oral and maxillofacial surgery. Methods Forty-seven students participating in the oral and maxillofacial surgery course at Karolinska Institutet during their final year were included. Three different oral surgery patient cases were created in a Virtual Patient (VP Simulation system (Web-SP and used for training clinical reasoning. A mandibular third molar surgery simulator with tactile feedback, providing hands on training in the bone removal and tooth sectioning in third molar surgery, was also tested. A seminar was performed using the combination of these two simulators where students' perception of the two different simulation methods was assessed by means of a questionnaire. Results The response rate was 91.5% (43/47. The students were positive to the VP cases, although they rated their possible improvement of clinical reasoning skills as moderate. The students' perception of improved technical skills after training in the mandibular third molar surgery simulator was rated high. The majority of the students agreed that both simulation techniques should be included in the curriculum and strongly agreed that it was a good idea to use the two simulators in concert. The importance of feedback from the senior experts during simulator training was emphasised. Conclusions The two tested simulation methods were well accepted and most

  18. A clinical comparison of two different prednisolone acetate formulations in patients undergoing cataract surgery.

    Science.gov (United States)

    Gayton, Johnny L

    2005-08-01

    This study was conducted to evaluate the efficacy of two topical steroid prednisolone preparations (Econopred Plus 1%, prednisolone acetate 1%: EPP; Pred Fortedagger 1%, prednisolone acetate 1%: PF) in reducing postoperative inflammation in cataract patients. This was a 4 week, randomized, parallel-group, single-center, active-controlled study. One group of patients received postoperative topical EPP while the other group received postoperative topical PF. Both medications were dosed 4 times per day for 14 days and then BID until the container was empty. Both groups of patients received diclofenac sodium QID for 14 days and hydroxypropyl guar (HP-Guar, Systane) QID for 7 days then PRN (or as directed). The presence of corneal surface keratitis, anterior chamber cells and flare (scales 0-3 for keratitis, 0-5 for cells and 0-4 for flare; 0 = none) was evaluated by slit lamp biomicroscopy. EPP produced significantly lower (P < 0.05) anterior chamber flare scores 14 days following surgery (mean +/- SD: 0.86 +/- 0.53) than PF (1.08 +/- 0.40). Otherwise, there were no differences observed between the 2 treatments with respect to keratitis, anterior chamber flare or cells at postop days 1, 7, or 28. This comparative trial demonstrated that both formulations of prednisolone acetate 1% have similar efficacy in the treatment of postoperative ophthalmologic inflammation.

  19. Microbiological analysis of bacterial plaque on three different threads in oral surgery.

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    Bucci, Marco; Borgonovo, Andrea; Bianchi, Albino; Zanellato, Anna; Re, Dino

    2017-02-01

    Suture is the final act of most oral surgery procedures. The quality of healing after the operation depends on its efficiency. Sutures must not cause inflammation - neither directly nor indirectly. The objective of this study is to compare the bacterial colonization on different suture materials after a third molar extraction. Thirty patients were randomly selected among people going under third molar extraction; they were divided into 3 groups and one suture type was used on each group. After 7 days distal stitches were removed by a single operator, placed in physiologic solution and analyzed after 2 or 3 hours. Patients followed the same postsurgical protocols; materials used were: Ethicon Silk® 4/0, B. Braun Dafilon® 4/0, and B. Braun Safil® 4/0. The amount of cocci and bacilli on the sutures analyzed shows that silk (Ethicon Silk) is the higher level of retention material where monofilament (B. Braun Dafilon) is the lower. There is a difference between monofilament and polyglycolide (B. Braun Safil), as the former is less retentive than the latter, although not significantly so. A less plaque retention, and consequently a fewer bacterial presence, is crucial to minimize the inflammatory process and allow a better tissue healing. Since the capability of brushing and, of course, the final personal hygiene depends on multiple variables, we must use surgical protocols able to minimize the effect of improper cleaning on the healing process: this statement implies the use of low plaque retention materials. The use of monofilament or polyglycolide threads in sutures can help reducing bacterial concentration and therefore promotes a faster and better healing.

  20. Thyroid cytology-nuclear versus architectural atypia within the "Atypia of undetermined significance/follicular lesion of undetermined significance" Bethesda category have significantly different rates of malignancy.

    Science.gov (United States)

    Gan, Tiffany Rui Xuan; Nga, Min En; Lum, Jeffrey Huey Yew; Wong, Wendy Meihua; Tan, Wee Boon; Parameswaran, Rajeev; Ngiam, Kee Yuan

    2017-04-01

    The Bethesda System for Reporting Thyroid Cytopathology is the most widely used classification system for the reporting of thyroid fine-needle aspiration cytology (FNAC) specimens. However, the "atypical" category ("atypia of undetermined significance" [AUS] or "follicular lesion of undetermined significance" [FLUS]) continues to cause diagnostic and therapeutic dilemmas. The objectives of this study were to describe the differential malignancy rates of FNACs diagnosed as AUS/FLUS based on nuclear or architectural atypia and to assess the significance of demographic and ultrasonographic features in predicting malignancy in this category. A retrospective review was performed of all thyroid FNACs between 2008 and 2014 that were diagnosed as AUS/FLUS at a tertiary referral center in Singapore. Patient demographics, preoperative ultrasonographic features, and follow-up data were collected and correlated with the final histopathologic diagnosis in resected cases. In total, 309 thyroid nodules were diagnosed as AUS/FLUS, and 137 (44%) were surgically excised. Final histology yielded 37 (27%) malignancies. The malignancy rate for nodules that featured nuclear atypia was significantly higher at 36.8% than the rate for nodules that had only architectural atypia at 14.7% (P < .01). After up to 3 repeat FNACs, 67.1% of cases had a more definitive diagnosis. The only predictive sonographic finding for malignancy was irregular margins (P < .01). The disparity between malignancy risks within the Bethesda "atypical" category suggests that cytologic (nuclear) atypia is significantly more predictive of malignancy than architectural atypia. This supports the substratification of patients according to risk and a corresponding management approach within this category. A sonographic finding of irregular margins is also predictive for malignancy. Cancer Cytopathol 2017;125:245-256. © 2016 American Cancer Society. © 2016 American Cancer Society.

  1. Comparison of three different formulations of local anaesthetics for cervical epidural anaesthesia during thyroid surgery

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    Gaurav Jain

    2012-01-01

    Full Text Available Background: To compare the efficacy and safety of local anaesthetics under cervical epidural anaesthesia (CEA using lignocaine (1%, bupivacaine (0.25% and ropivacaine (0.5% for thyroid surgery. Methods: In a prospective, randomized fashion, 81 patients were selected for thyroid surgery under CEA. They were assigned to one of three groups: Group L, B and R to receive 10 mL of 1% lignocaine, 0.25% bupivacaine and 0.5% ropivacaine, respectively. We compared their efficacy in terms of pulmonary and haemodynamic parameters, blockade quality and complications. Results: Of the total, 74 patients completed the study successfully. Sensory block attained the median dermatomal range of C2-T4/T5 in all the groups. Motor block was more pronounced in the ropivacaine group. Cardiorespiratory parameters decreased significantly in all the groups; however, none of the patients had any major complications except for bradycardia in two patients. Among the measured variables, the decrease in heart rate and peak expiratory force was more in the lignocaine group while forced vital capacity and forced expiratory volume at 1 sec declined to a greater extent in the ropivacaine group. The lignocaine group required significantly more epidural top-ups compared with the other two groups. Conclusion: We conclude that cervical epidural route can be safely used for surgery on thyroid gland in patients with normal cardiorespiratory reserve, using either of local anaesthetics chosen for our study. Under the selected dose and concentrations, the decrease in cardiorespiratory parameters was lesser with bupivacaine.

  2. Off pump coronary artery bypass surgery for significant left ventricular dysfunction: safety, feasibility, and trends in methodology over time—an early experience

    Science.gov (United States)

    Sharoni, E; Song, H K; Peterson, R J; Guyton, R A; Puskas, J D

    2006-01-01

    Objective To examine the safety and applicability of off pump coronary artery bypass surgery (OPCAB) in patients with significant left ventricular dysfunction and to discuss the clinical implications for the surgical methods. Design Retrospective study. Setting Tertiary care university affiliated referral centre. Participants 353 consecutive patients with preoperative left ventricular ejection fraction ⩽ 35% who underwent coronary artery bypass over a three year period. Main outcome measures Postoperative morbidity and mortality. Methods 144 patients operated by OPCAB were compared with 209 patients operated by conventional coronary artery bypass. Multivariate and univariate analyses were performed on the pre‐ and postoperative variables to predict risk factors associated with hospital morbidity and mortality. Results Patients in the OPCAB group were more likely to be women and to have congestive heart failure, chronic obstructive pulmonary disease, hypertension, and diabetes; patients in the on pump group were more likely to have had a recent myocardial infarction and to have more severe angina pectoris and an urgent/emergent status. The groups did not differ significantly in length of stay, major postoperative complication rates, or mortality. Comparison of the impact of the procedures on surgical methods over time showed an increase in the use of OPCAB (13% to 67%), without any impact on morbidity or mortality. Conclusions OPCAB is feasible and applicable for patients with depressed left ventricular function. This high risk group can potentially benefit from the off pump approach. PMID:15994913

  3. Effects of different cutting centers on LASIK surgery in myopic patients

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    Yan-Wei Liu

    2017-07-01

    Full Text Available AIM:To investigate the effect of different cutting centers on the visual acuity, refractive diopter and visual quality of patients undergoing laser assisted in situ keratomileusis(LASIK. METHODS: A total of 80 patients(160 eyeswith myopia treated by elective LASIK were divided into two groups. Thirty-six cases(72 eyeswith visual axis corneal reflection point(VACRPas the cutting center were included into the VACRP group while 44 cases(88 eyeswith pupil center(PCas the cutting center were included into the PC group. The uncorrected visual acuity(UCVA, the best corrected visual acuity(BCVA, refractive diopter, corneal aberration \\〖total corneal and anterior corneal surface higher-order aberrations(HOA, spherical aberration(Z40, vertical coma(Z3-1, horizontal coma(totZ31and offset of cutting centers were determined before surgery and 1mo after surgery. RESULTS: There was no difference in the probability of UCVA ≥ 0.1, BCVA and refractive diopter between the two groups at 1mo after surgery(P>0.05. The astigmatism and cutting center deviation of VACRP group were lower than those of PC group(P40, totZ3-1, totZ31, froHOA, froZ3-1、froZ31 and froZ40 were lower in VACRP group than PC group at 1mo after surgery(PCONCLUSION: The UCVA of patients treated with both cutting centers for LASIK is good but VACRP has more advantages in reducing the offset of cutting center and improving postoperative visual quality.

  4. Differences between Total Intravenous Anesthesia and Inhalation Anesthesia in Free Flap Surgery of Head and Neck Cancer.

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    Yi-Ting Chang

    Full Text Available Many studies have evaluated risk factors associated with complications after free flap surgery, but these studies did not evaluate the impact of anesthesia management. The goal of the current study was to evaluate the differences between patients who received inhalation and total intravenous anesthesia (TIVA in free flap surgery.One hundred and fifty-six patients who underwent free flap surgery for head and neck cancer were retrospectively divided into the TIVA (96 patients and the inhalation group (87 patients. Perioperative hemodynamic data and postoperative medical complications were determined by documented medical records.Ninety-six patients in the TIVA group were compared with 87 patients who received inhalation anesthesia. There were no differences in gender, age, classification of physical status based on American Society for Anesthesiologists (ASA score, and cormobidities between the two groups. Patients in the TIVA group required less perioperative crystalloid (4172.46 ± 1534.95 vs. 5183.91 ± 1416.40 ml, p < 0.0001 and colloid (572.46 ± 335.14 vs. 994.25 ± 434.65 ml, p < 0.0001 to maintain hemodynamic stability. Although the mean anesthesia duration was shorter in the TIVA group (11.02 ± 2.84 vs. 11.70± 1.96 hours, p = 0.017, the blood loss was similar between groups (p = 0.71. There was no difference in surgical complication rate, but patients in the TIVA group developed fewer pulmonary complications (18 vs. 47, p = 0.0008. After multivariate regression, patients in the TIVA group had a significantly reduced risk of pulmonary complication compared with the inhalation group (Odds ratio 0.41, 95% CI 0.18-0.92.Total intravenous anesthesia was associated with significantly fewer pulmonary complications in patients who received free flap reconstruction.

  5. Estimating significances of differences between slopes: A new methodology and software

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    Vasco M. N. C. S. Vieira

    2013-09-01

    Full Text Available Determining the significance of slope differences is a common requirement in studies of self-thinning, ontogeny and sexual dimorphism, among others. This has long been carried out testing for the overlap of the bootstrapped 95% confidence intervals of the slopes. However, the numerical random re-sampling with repetition favours the occurrence of re-combinations yielding largely diverging slopes, widening the confidence intervals and thus increasing the chances of overlooking significant differences. To overcome this problem a permutation test simulating the null hypothesis of no differences between slopes is proposed. This new methodology, when applied both to artificial and factual data, showed an enhanced ability to differentiate slopes.

  6. Differences in Clinical Features Between Subcategories of "Atypia/Follicular Lesion of Undetermined Significance".

    Science.gov (United States)

    Kim, Seong Dong; Han, Seung Hoon; Jeong, Woo-Jin; Kim, Hyojin; Ahn, Soon Hyun

    2017-05-09

    Within the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), category III (atypia or follicular lesion of undetermined significance (AUS/FLUS)) comprises specimens with heterogeneous features and the need for subcategorization has been reported. We compared the clinical features of two subgroups from within the category of AUS/FLUS to determine precise guidelines for clinicians who explain the results of fine-needle aspiration (FNA) to patients. Retrospective review was performed including data from all patients who underwent FNA with results reported as AUS/FLUS at a single tertiary hospital from January 2010 to August 2014. The results of repeated FNA, core needle biopsy, and diagnostic surgery were analyzed. Of the 903 patients with results categorized as AUS/FLUS, 500 were subcategorized as cellular atypia and 160 as architectural atypia. On repeated biopsy, diagnostic results were obtained for 78.9% patients of the cellular atypia group, compared to only 54.3% of the architectural atypia group (p < 0.0001). The rate of neoplasm or malignancy was also significantly higher in the cellular atypia group compared to the architectural atypia group (51.8 vs. 25.2%, p < 0.0001, 48.2 vs. 14.2%, p < 0.0001). Therefore, clinicians can inform patients with architectural atypia that the risk of malignancy is low. However, the high rate of non-diagnostic results on repeated biopsy makes clinical decisions difficult. The data of the present study revealed the necessity of subcategorization of category III of TBSRTC in the future.

  7. Minimal important difference after hand surgery: a prospective assessment for DASH, MHQ, and SF-12

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    Maia, Maurício Vieira de Pádua; de Moraes, Vinícius Ynoe; dos Santos, João Baptista Gomes; Faloppa, Flávio; Belloti, João Carlos

    2016-01-01

    Introduction: Minimal important difference (MID) score is an important measure for surgical clinical research and impacts on treatment decisions. Our approach considered patient satisfaction as the relevant anchor criteria. The aims of this study were: determine after surgery MID for three relevant questionnaires: Disabilities of the Arm, Shoulder and Hand (DASH), Michigan Hand Questionnaire (MHQ), and Short Form 12 (SF-12); and assess the correlation between these scores and patient reported satisfaction. Methods: Adult patients where surgery was indicated for any hand/wrist conditions. Study was conducted in a teaching hospital, São Paulo, Brazil. Participants responded to DASH, SF-12, MHQ, and a Likert satisfaction scale before and three months after a procedure. Satisfaction was considered as the anchor for determining MID after a procedure. The correlation between satisfaction and the instruments were measured. Two statistical approaches were utilized for determining MIDs and were used for consistency and generalizability purposes. For MID determination, receiver operating curves were utilized and MID cut-offs were followed by sensitivity and specificity measures. Results: Fifty patients were included with no follow-up losses. MID for DASH was 18.8 and 15.4. MID for MHQ was 14.7 for both approaches. Data from SF-12 was not reliable after statistical analyses and demonstrated poor correlation with patient satisfaction. MID for DASH and MHQ were found and demonstrated larger standards than literature-reported patients when surgery was not the main intervention. DASH and MHQ had moderate correlation with patient reported satisfaction. SF-12 MID was not reliable and had poor correlation to patient satisfaction. These data suggests that ambulatory hand surgery patients may have greater expectations regarding improvement than other patients. PMID:27716460

  8. No significant difference in antigenicity or tissue transglutaminase substrate specificity of Irish and US wheat gliadins.

    Science.gov (United States)

    Keaveny, A P; Offner, G D; Bootle, E; Nunes, D P

    2000-04-01

    The prevalence of clinical celiac disease has been shown to vary both across time and between genetically similar populations. Differences in wheat antigenicity and transglutaminase substrate properties are a possible explanation for these differences. This study assessed the antigenicity and transglutaminase substrate specificities of gliadins from regions of high and low celiac disease prevalence. Gliadin was extracted from three commercial US wheat sources and two Irish sources. SDS-PAGE and western blotting revealed minor, but significant variations in the gliadin extracts. However, ELISA showed no difference in the antigenicity of these gliadins. Transglutaminase pretreatment of gliadin resulted in no significant change in gliadin antigenicity and kinetic studies showed that the Kms of the various gliadins were very similar. Purified IgA and IgG had no effect on transglutaminase activity. In summary, minor variations in wheat gliadins are unlikely to explain the observed differences in disease expression across genetically similar populations.

  9. Description of sex difference as prescription for sex change: on the origins of facial feminization surgery.

    Science.gov (United States)

    Plemons, Eric D

    2014-10-01

    This article explores the research project that led to the development of facial feminization surgery, a set of bone and soft tissue reconstructive surgical procedures intended to feminize the faces of male-to-female trans- women. Conducted by a pioneering surgeon in the mid-1980s, this research consisted of three steps: (1) assessments of sexual differences of the skull taken from early 20th-century physical anthropology, (2) the application of statistical analyses taken from late 20th-century orthodontic research, and (3) the vetting of this new morphological and metric knowledge in a dry skull collection. When the 'feminine type' of early 20th-century physical anthropology was made to articulate with the 'female mean' of 1970s' statistical analysis, these two very different epistemological artifacts worked together to produce something new: a singular model of a distinctively female skull. In this article, I show how the development of facial feminization surgery worked across epistemic styles, transforming historically racialized and gendered descriptions of sex difference into contemporary surgical prescriptions for sex change. Fundamental to this transformation was an explicit invocation of the scientific origins of facial sexual dimorphism, a claim that frames surgical sex change of the face as not only possible, but objectively certain.

  10. Significance of preoperative calculation of uterine weight as an indicator for preserving the uterus in pelvic reconstructive surgery.

    Science.gov (United States)

    Sheng, Qingsong; Ma, Ning; Huang, Huijuan; Xu, Bo; He, Chunni; Song, Yanfeng

    2015-01-01

    Recently, increasing evidence has shown that uterus preservation is beneficial for pelvic organ prolapse (POP) patients, both physiologically and psychologically. However, the preoperative indicators for uterus preservation have rarely been examined. The current study was designed to determine the relationship between the preoperative evaluated uterus weight and the operation selection (preserving the uterus or not) in pelvic reconstructive surgery (PRS) using vaginal meshes. First, in a series of 96 patients undergoing hysterectomy, the uterine weight was calculated by preoperative ultrasound measurements, and was then compared with the postoperative actual weight of the uterus. Subsequently, in a series of 65 patients undergone PRS using vaginal meshes and preserving the uterus, the uterine weight was calculated by preoperative ultrasound measurements. Lastly, in a series of 43 patients with a uterine weight > 56.12 g who had undergone PRS using vaginal meshes, the operation success rate in patients with a preserved uterus was compared to patients for whom the uterus was not preserved. The results showed that uterus weight can be evaluated by ultrasound and used as a preoperative indicator for whether the uterus should be preserved or not in PRS when using vaginal meshes. It was indicated that preoperative evaluation of uterine weight is beneficial for surgical planning and guidance.

  11. Different degrees of plant invasion significantly affect the richness of the soil fungal community.

    Directory of Open Access Journals (Sweden)

    Chuncan Si

    Full Text Available Several studies have shown that soil microorganisms play a key role in the success of plant invasion. Thus, ecologists have become increasingly interested in understanding the ecological effects of biological invasion on soil microbial communities given continuing increase in the effects of invasive plants on native ecosystems. This paper aims to provide a relatively complete depiction of the characteristics of soil microbial communities under different degrees of plant invasion. Rhizospheric soils of the notorious invasive plant Wedelia trilobata with different degrees of invasion (uninvaded, low-degree, and high-degree using its coverage in the invaded ecosystems were collected from five discrete areas in Hainan Province, P. R. China. Soil physicochemical properties and community structure of soil microorganisms were assessed. Low degrees of W. trilobata invasion significantly increased soil pH values whereas high degrees of invasion did not significantly affected soil pH values. Moreover, the degree of W. trilobata invasion exerted significant effects on soil Ca concentration but did not significantly change other indices of soil physicochemical properties. Low and high degrees of W. trilobata invasion increased the richness of the soil fungal community but did not pose obvious effects on the soil bacterial community. W. trilobata invasion also exerted obvious effects on the community structure of soil microorganisms that take part in soil nitrogen cycling. These changes in soil physicochemical properties and community structure of soil microbial communities mediated by different degrees of W. trilobata invasion may present significant functions in further facilitating the invasion process.

  12. Different degrees of plant invasion significantly affect the richness of the soil fungal community.

    Science.gov (United States)

    Si, Chuncan; Liu, Xueyan; Wang, Congyan; Wang, Lei; Dai, Zhicong; Qi, Shanshan; Du, Daolin

    2013-01-01

    Several studies have shown that soil microorganisms play a key role in the success of plant invasion. Thus, ecologists have become increasingly interested in understanding the ecological effects of biological invasion on soil microbial communities given continuing increase in the effects of invasive plants on native ecosystems. This paper aims to provide a relatively complete depiction of the characteristics of soil microbial communities under different degrees of plant invasion. Rhizospheric soils of the notorious invasive plant Wedelia trilobata with different degrees of invasion (uninvaded, low-degree, and high-degree using its coverage in the invaded ecosystems) were collected from five discrete areas in Hainan Province, P. R. China. Soil physicochemical properties and community structure of soil microorganisms were assessed. Low degrees of W. trilobata invasion significantly increased soil pH values whereas high degrees of invasion did not significantly affected soil pH values. Moreover, the degree of W. trilobata invasion exerted significant effects on soil Ca concentration but did not significantly change other indices of soil physicochemical properties. Low and high degrees of W. trilobata invasion increased the richness of the soil fungal community but did not pose obvious effects on the soil bacterial community. W. trilobata invasion also exerted obvious effects on the community structure of soil microorganisms that take part in soil nitrogen cycling. These changes in soil physicochemical properties and community structure of soil microbial communities mediated by different degrees of W. trilobata invasion may present significant functions in further facilitating the invasion process.

  13. Perioperative concerns in pediatric patients undergoing different types of scoliosis correction surgery: A retrospective observational study

    Directory of Open Access Journals (Sweden)

    Anjolie Chhabra

    2013-01-01

    Patients and Methods: After taking parental consent, data were collected retrospectively for 33 patients who underwent 37 procedures (four patients had both anterior and posterior procedures on 2 days of the week mainly from August 2008 to February 2010 at a tertiary care institution. Results: Children undergoing GR surgery were younger (8.1 ± 2.1 years than patients undergoing AR (12.9 ± 1.7 years or posterior fusion (14.2 ± 2.2 years. AR children had a significantly higher Cobb′s angle and more rigid curves. (P = 0.057 Associated congenital abnormalities especially neurological were commoner in the GR children. Surgical duration and blood loss was significantly more for PF (2207.5 ± 1224.13 ml than GR (456 ± 337.5 ml, or AR (642.85 ± 304.72 ml, (P = 0.0002. PF patients needed Intensive care unit (ICU care mainly due to the blood loss and prolonged surgery (35%. AR performed via thoracotomy was associated with the need for mechanical ventilation in 28.6%. The GR patients had major intraoperative hemodynamic events and 20% needed ICU care. Conclusions: Post-operative ventilation may be required in 20-35% patients undergoing procedures for scoliosis correction. Despite GR insertion involving lesser blood loss; younger age, congenital abnormalities, positioning, and surgical manipulation resulted in life threatening events in these patients.

  14. Differences in perioperative femoral and radial arterial blood pressure in neonates and infants undergoing pediatric cardiac surgery requiring cardiopulmonary bypass.

    Science.gov (United States)

    Cho, Hwa Jin; Lee, Sang Hoon; Jeong, In Seok; Yoon, Nam Sik; Ma, Jae Sook; Ahn, Byoung Hee

    2017-08-30

    Several reports claim that blood pressure (BP) in the radial artery may underestimate the accurate BP in critically ill patients. Here, the authors evaluated differences in mean blood pressure (MBP) between the radial and femoral artery during pediatric cardiac surgery to determine the effectiveness of femoral arterial BP monitoring. The medical records of children under 1 year of age who underwent open-heart surgery between 2007 and 2013 were retrospectively reviewed. Radial and femoral BP were measured simultaneously, and the differences between these values were analyzed at various times: after catheter insertion, after the initiation of cardiopulmonary bypass (CPB-on), after aortic cross clamping (ACC), after the release of ACC, after weaning from CPB, at arrival in the intensive care unit (ICU), and every 6h during the first day in the ICU. A total of 121 patients who underwent open-heart surgery met the inclusion criteria. During the intraoperative period, from the beginning to the end of CPB, radial MBPs were significantly lower than femoral MBPs at each time-point measured (p60min, odds ratio: 7.47) was a risk factor for lower radial pressure. However, discrepancies between these two values disappeared after arrival in the ICU. There was no incidence of ischemic complications associated with the catheterization of both arteries. The authors suggest that femoral arterial pressure monitoring can be safely performed, even in neonates, and provides more accurate BP values during CPB-on periods, and immediately after weaning from CPB, especially when CPB time was greater than 60min. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  15. Differing coagulation profiles of patients with monoclonal gammopathy of undetermined significance and multiple myeloma.

    Science.gov (United States)

    Crowley, Maeve P; Crowely, Maeve P; Quinn, Shane; Coleman, Eoin; Eustace, Joseph A; Gilligan, Oonagh M; O'Shea, Susan I; Shea, Susan I O

    2015-02-01

    The link between myeloma and thrombosis is well established. Monoclonal gammopathy of undetermined significance (MGUS) has also been associated with an increased risk of thrombosis. It was recently demonstrated that patients with myeloma display changes in thromboelastometry that may indicate a prothrombotic state. There is little data with regard to changes in thromboelastography in patients with myeloma or MGUS. The aim of this study was to investigate the differing coagulation profiles of patients of patients with myeloma and MGUS by means of conventional coagulation tests and thromboelastography. Blood was taken by direct venepuncture from patients with myeloma, MGUS and normal controls. Routine coagulation tests were performed in an accredited hospital laboratory. Thromboelastography (TEG(®)) was performed as per the manufacturer's protocol. Eight patients were recruited in each group. Patients with myeloma had a significantly lower mean haemoglobin level than patients with MGUS or normal controls (p < 0.001). Patients with myeloma had a significantly more prolonged mean prothrombin time than normal controls (p = 0.018) but not patients with MGUS. Patients with myeloma had significantly higher median D-dimer levels than normal controls (p = 0.025), as did patients with MGUS (p = 0.017). Patients with myeloma had a significantly higher mean factor VIII level than normal controls (p = 0.009) and there was a non-significant trend towards patients with MGUS having higher factor VIII levels than normal controls (p = 0.059). There was no significant difference in thromboelastographic parameters between the three groups. Patients with MGUS appear to have a distinct coagulation profile which is intermediate between patients with myeloma and normal controls.

  16. Significance analysis of the regional differences on icing time of water onto fire protective clothing

    Science.gov (United States)

    Zhao, L. Z.; Jing, L. S.; Zhang, X. Z.; Xia, J. J.; Chen, Y.; Chen, T.; Hu, C.; Bao, Z. M.; Fu, X. C.; Wang, R. J.; Wang, Y.; Wang, Y. J.

    2017-09-01

    The object of this work was to determine the icing temperature in icing experiment. Firstly, a questionnaire investigation was carried out on 38 fire detachments in different regions. These Statistical percentage results were divided into northern east group and northern west group. Secondly, a significance analysis between these two results was made using Mann-Whitney U test. Then the icing temperature was determined in different regions. Thirdly, the icing experiment was made in the environment of -20°C in Daxing’an Mountain. The anti-icing effect of new fire protective clothing was verified in this icing.

  17. Orthognathic Surgery

    DEFF Research Database (Denmark)

    Kjærgaard Larsen, Marie; Thygesen, Torben Henrik

    2016-01-01

    The literature shows that the indications for orthognathic surgery (OS) are often functional problems and unsatisfactory facial esthetics. This study investigated the esthetic outcomes and overall satisfaction following OS. Somatosensory change is a relatively common complication and its influence...... on the level of satisfaction was studied. The social-networking web site Facebook was used to identify the study population. An online questionnaire was performed using the website SurveyMonkey. In all, 105 (9%) respondents from the Danish Facebook group about OS, called Kaebeoperation (jaw surgery), were...... in beauty than women (P = 0.030). Sixty-four percent replied that their attractiveness had been increased after OS. Eighty-six percent were happy with the results and 89% would recommend the surgery to others in need. No significant differences in esthetic results and satisfaction were seen with regard...

  18. No gender differences in prognosis and preventive treatment in patients with AMI without significant stenoses

    DEFF Research Database (Denmark)

    Hansen, Kim Wadt; Hvelplund, Anders; Abildstrøm, Steen Zabell

    2012-01-01

    Objective: To investigate possible gender differences in patients with acute myocardial infarction (AMI) and without significant stenoses on coronary angiography (CAG) regarding prognosis and use of secondary preventive medication. Design: Nationwide register-based cohort study. Patients: By comp......Objective: To investigate possible gender differences in patients with acute myocardial infarction (AMI) and without significant stenoses on coronary angiography (CAG) regarding prognosis and use of secondary preventive medication. Design: Nationwide register-based cohort study. Patients...... a prescription for a lipid-lowering drug, beta-blocker, clopidogrel, or aspirin within 60 days of discharge. Results: During follow-up, 97 women and 60 men died, resulting in a crude female/male hazard ratio (HR) of 1.51 (95% CI 1.09-2.08). After adjustment for age, time-period, and comorbidity, the gender...

  19. Significant differences in physicochemical properties of human immunoglobulin kappa and lambda CDR3 regions

    Directory of Open Access Journals (Sweden)

    Catherine L Townsend

    2016-09-01

    Full Text Available Antibody variable regions are composed of a heavy and a light chain and in humans there are two light chain isotypes: kappa and lambda. Despite their importance in receptor editing, the light chain is often overlooked in the antibody literature, with the focus being on the heavy chain CDR-H3 region. In this paper, we set out to investigate the physicochemical and structural differences between human kappa and lambda light chain CDR regions. We constructed a dataset containing over 29,000 - light chain variable region sequences from IgM-transcribing, newly formed B cells isolated from human bone marrow and peripheral blood. We also used a published human naïve dataset to investigate the CDR-H3 properties of heavy chains paired with kappa and lambda light chains, and probed the Protein Data Bank (PDB to investigate the structural differences between kappa and lambda antibody CDR regions. We found that kappa and lambda light chains have very different CDR physicochemical and structural properties, whereas the heavy chains with which they are paired do not differ significantly. We also observed that the mean CDR3 N nucleotide addition in the kappa, lambda and heavy chain gene rearrangements are correlated within donors, but can differ between donors. This indicates that TdT may work with differing efficiencies between different people, but the same efficiency in the different classes of immunoglobulin chain within one person. We have observed large differences in the physicochemical and structural properties of kappa and lambda light chain CDR regions. This may reflect different roles in the humoral immune response.

  20. Significant Differences in Physicochemical Properties of Human Immunoglobulin Kappa and Lambda CDR3 Regions.

    Science.gov (United States)

    Townsend, Catherine L; Laffy, Julie M J; Wu, Yu-Chang Bryan; Silva O'Hare, Joselli; Martin, Victoria; Kipling, David; Fraternali, Franca; Dunn-Walters, Deborah K

    2016-01-01

    Antibody variable regions are composed of a heavy and a light chain, and in humans, there are two light chain isotypes: kappa and lambda. Despite their importance in receptor editing, the light chain is often overlooked in the antibody literature, with the focus being on the heavy chain complementarity-determining region (CDR)-H3 region. In this paper, we set out to investigate the physicochemical and structural differences between human kappa and lambda light chain CDR regions. We constructed a dataset containing over 29,000 light chain variable region sequences from IgM-transcribing, newly formed B cells isolated from human bone marrow and peripheral blood. We also used a published human naïve dataset to investigate the CDR-H3 properties of heavy chains paired with kappa and lambda light chains and probed the Protein Data Bank to investigate the structural differences between kappa and lambda antibody CDR regions. We found that kappa and lambda light chains have very different CDR physicochemical and structural properties, whereas the heavy chains with which they are paired do not differ significantly. We also observed that the mean CDR3 N nucleotide addition in the kappa, lambda, and heavy chain gene rearrangements are correlated within donors but can differ between donors. This indicates that terminal deoxynucleotidyl transferase may work with differing efficiencies between different people but the same efficiency in the different classes of immunoglobulin chain within one person. We have observed large differences in the physicochemical and structural properties of kappa and lambda light chain CDR regions. This may reflect different roles in the humoral immune response.

  1. Supra- and infratentorial pediatric ependymomas differ significantly in NeuN, p75 and GFAP expression.

    Science.gov (United States)

    Hagel, Christian; Treszl, András; Fehlert, Julia; Harder, Jonas; von Haxthausen, Franziska; Kern, Meike; von Bueren, André O; Kordes, Uwe

    2013-04-01

    Ependymomas comprise 8 % of all intracranial tumors in children infratentorial tumors and GFAP to be expressed at significantly higher levels in infratentorial lesions. In conclusion, immunohistochemical expression of p75, NeuN and GFAP differed in ependymomas depending on tumor topography supporting the view of divergent cells of origin. However, because of the small sample size the results are of preliminary nature and replication in a larger cohort would be desirable.

  2. Magnetic resonance imaging detects significant sex differences in human myocardial strain

    Directory of Open Access Journals (Sweden)

    Reynolds Lina M

    2011-08-01

    Full Text Available Abstract Background The pathophysiology responsible for the significant outcome disparities between men and women with cardiac disease is largely unknown. Further investigation into basic cardiac physiological differences between the sexes is needed. This study utilized magnetic resonance imaging (MRI-based multiparametric strain analysis to search for sex-based differences in regional myocardial contractile function. Methods End-systolic strain (circumferential, longitudinal, and radial was interpolated from MRI-based radiofrequency tissue tagging grid point displacements in each of 60 normal adult volunteers (32 females. Results The average global left ventricular (LV strain among normal female volunteers (n = 32 was significantly larger in absolute value (functionally better than in normal male volunteers (n = 28 in both the circumferential direction (Male/Female = -0.19 ± 0.02 vs. -0.21 ± 0.02; p = 0.025 and longitudinal direction (Male/Female = -0.14 ± 0.03 vs. -0.16 ± 0.02; p = 0.007. Conclusions The finding of significantly larger circumferential and longitudinal LV strain among normal female volunteers suggests that baseline contractile differences between the sexes may contribute to the well-recognized divergence in cardiovascular disease outcomes. Further work is needed in order to determine the pathologic changes that occur in LV strain between women and men with the onset of cardiovascular disease.

  3. Significance of different microalgal species for growth of moon jellyfish ephyrae, Aurelia sp.1

    Science.gov (United States)

    Zheng, Shan; Sun, Xiaoxia; Wang, Yantao; Sun, Song

    2015-10-01

    The scyphozoan Aurelia aurita (Linnaeus) sp. l., is a cosmopolitan species-complex which blooms seasonally in a variety of coastal and shelf sea environments around the world. The effects of different microalgal species on the growth of newly-released Aurelia sp.1 ephyrae were studied under laboratory conditions. We fed ephyrae with four different microalgal species (diatom, autotrophic dinoflagellate, heterotrophic dinoflagellate, and chlorophyta) plus Artemia nauplii for 12-24 d at 18°C. Results showed that the growth rate diverged significantly for Artemia nauplii compared to other food types. In addition, there was no significant variation between the growth rates for Skeletonema costatum and Prorocentrum donghaiense, and no significant variation was found in the growth rates for N. scintillans and P. subcordiformis. Artemia nauplii could support the energy requirement for the newly-released ephyrae to develop to meduase, and the ephyrae with Artemia nauplii showed a significant average growth rate of 25.85% d-1. Newly-released ephyrae could grow slightly with some species of microalgae in the earliest development stage. Chain diatom Skeletonema costatum and autotrophic dinoflagellate Prorocentrum donghaiense, could not support the growth of the ephyrae, while heterotrophic dinoflagellate Noctiluca scintillans and chlorophyta Platymonas subcordiformis could support the growth of the ephyrae. However, none of the ephyrae fed with the tested phytoplankton could mature to medusae.

  4. Comparative analysis of the Shadoo gene between cattle and buffalo reveals significant differences.

    Directory of Open Access Journals (Sweden)

    Hui Zhao

    Full Text Available BACKGROUND: While prions play a central role in the pathogenesis of transmissible spongiform encephalopathies, the biology of these proteins and the pathophysiology of these diseases remain largely unknown. Since no case of bovine spongiform encephalopathy (BSE has ever been reported in buffalo despite their phylogenetic proximity to cattle, genetic differences may be driving the different susceptibilities of these two species to BSE. We thus hypothesized that differences in expression of the most recently identified member of the prion family or Shadoo (SPRN gene may relate to these species-specific differences. PRINCIPAL FINDINGS: We first analyzed and compared the polymorphisms of the SPRN gene (~4.4 kb, including the putative promoter, coding and 3' regions, and further verified the entire ORF and putative promoter. This yielded a total of 117 fixed differences, remarkably: 1 a 12-bp insertion/deletion polymorphism in the hydrophobic domain of the cattle but not buffalo gene, introducing a four amino acid expansion/contraction in a series of 5 tandem Ala/Gly-containing repeats; 2 two fixed missense mutations (102Ser→Gly and 119Thr→Ala, and three missense mutations (92Pro>Thr/Met, 122Thr>Ile and 139Arg>Trp in the coding region presenting different (P<0.05 genotypic and allelic frequency distributions between cattle and buffalo; and, 3 functional luciferase-reporter experiments for the predicted promoter region, consistent with a significantly higher activity in buffalo than cattle. Supporting these findings, immunoblotting revealed higher relative expression levels of Sho protein in cerebrum from buffalo than from cattle. In addition, for cattle, highest Sho expression was detected in obex, as compared to cerebrum or cerebellum. SIGNIFICANCE: Our findings support Sho as a non-PrP specific marker for prion infections, with obex as the best tissue source for the detection of Sho in TSE rapid tests. Moreover, these discoveries may prove

  5. Lipid peroxidation and antioxidants in different stages of cervical cancer: Prognostic significance

    Directory of Open Access Journals (Sweden)

    S Srivastava

    2009-01-01

    Full Text Available Background: Free radical Injury is associated with cancer, but how the extent of oxidative stress correlates with the FIGO (International Federation of Gynecology and Obstetrics stage in Carcinoma Cervix (Ca Cx, and its significance as a prognostic marker, is not clear and needs an in-depth study. Aim: To correlate the blood levels of Lipid Peroxidation (LPO, Reduced Glutathione (GSH, Superoxide Dismutase (SOD, and Vitamin A and E levels with the clinical stage in Ca Cx. Settings and Design: This is a Prospective Case Control Study. Materials and Methods: LPO, SOD, reduced GSH were estimated by Bio Chemical Assays and Vitamins by High Performance Liquid Chromatography (HPLC. Statistical Analysis: The cases and controls were compared using One Way ANOVA and different stages over different time periods were individually compared by Repeated Measure Analysis of Variance. Results: The results indicated a statistically significant increase of LPO vis-a-vis the FIGO stage of Ca Cx and control, while the antioxidant status as depicted by GSH and SOD decreased. Vitamin A and E levels were significantly lower in cancer cases as compared to the control. Conclusion: Increased LPO and reduced antioxidant levels may be taken as associated predictive markers, thus suggesting that Ca Cx cases should get nutritive supplements to contain the blood LPO level and maintain a positive balance of antioxidants for a better outcome in terms of delayed recurrence and better Quality of Life (QOL.

  6. Subthalamic Nucleus Deep Brain Stimulation Modulate Catecholamine Levels with Significant Relations to Clinical Outcome after Surgery in Patients with Parkinson’s Disease

    Science.gov (United States)

    Yamamoto, Tatsuya; Uchiyama, Tomoyuki; Higuchi, Yoshinori; Asahina, Masato; Hirano, Shigeki; Yamanaka, Yoshitaka; Kuwabara, Satoshi

    2015-01-01

    Aims Although subthalamic nucleus deep brain stimulation (STN-DBS) is effective in patients with advanced Parkinson’s disease (PD), its physiological mechanisms remain unclear. Because STN-DBS is effective in patients with PD whose motor symptoms are dramatically alleviated by L-3,4-dihydroxyphenylalanine (L-DOPA) treatment, the higher preoperative catecholamine levels might be related to the better clinical outcome after surgery. We aimed to examine the correlation between the preoperative catecholamine levels and postoperative clinical outcome after subthalamic nucleus deep brain stimulation. The effectiveness of STN-DBS in the patient who responded well to dopaminergic medication suggest the causal link between the dopaminergic system and STN-DBS. We also examined how catecholamine levels were modulated after subthalamic stimulation. Methods In total 25 patients with PD were enrolled (Mean age 66.2 ± 6.7 years, mean disease duration 11.6 ± 3.7 years). Mean levodopa equivalent doses were 1032 ± 34.6 mg before surgery. Cerebrospinal fluid and plasma catecholamine levels were measured an hour after oral administration of antiparkinsonian drugs before surgery. The mean Unified Parkinson’s Disease Rating Scale scores (UPDRS) and the Parkinson’s disease Questionnaire-39 (PDQ-39) were obtained before and after surgery. Of the 25 patients, postoperative cerebrospinal fluid and plasma were collected an hour after oral administration of antiparkinsonian drugs during on stimulation at follow up in 11 patients. Results Mean levodopa equivalent doses significantly decreased after surgery with improvement in motor functions and quality of life. The preoperative catecholamine levels had basically negative correlations with postoperative motor scores and quality of life, suggesting that higher preoperative catecholamine levels were related to better outcome after STN-DBS. The preoperative plasma levels of L-DOPA had significantly negative correlations with

  7. Using the Bootstrap Method for a Statistical Significance Test of Differences between Summary Histograms

    Science.gov (United States)

    Xu, Kuan-Man

    2006-01-01

    A new method is proposed to compare statistical differences between summary histograms, which are the histograms summed over a large ensemble of individual histograms. It consists of choosing a distance statistic for measuring the difference between summary histograms and using a bootstrap procedure to calculate the statistical significance level. Bootstrapping is an approach to statistical inference that makes few assumptions about the underlying probability distribution that describes the data. Three distance statistics are compared in this study. They are the Euclidean distance, the Jeffries-Matusita distance and the Kuiper distance. The data used in testing the bootstrap method are satellite measurements of cloud systems called cloud objects. Each cloud object is defined as a contiguous region/patch composed of individual footprints or fields of view. A histogram of measured values over footprints is generated for each parameter of each cloud object and then summary histograms are accumulated over all individual histograms in a given cloud-object size category. The results of statistical hypothesis tests using all three distances as test statistics are generally similar, indicating the validity of the proposed method. The Euclidean distance is determined to be most suitable after comparing the statistical tests of several parameters with distinct probability distributions among three cloud-object size categories. Impacts on the statistical significance levels resulting from differences in the total lengths of satellite footprint data between two size categories are also discussed.

  8. Comparison of AOD between CALIPSO and MODIS: significant differences over major dust and biomass burning regions

    Directory of Open Access Journals (Sweden)

    X. Ma

    2013-09-01

    Full Text Available Cloud–Aerosol Lidar and Infrared Pathfinder Satellite Observations (CALIPSO provide global vertical profiles of aerosol optical properties for the first time. In this study, we employed about 6 yr (2006–2011 of CALIPSO level 3 monthly mean gridded aerosol optical depth (AOD products (daytime and nighttime for cloud-free conditions, to compare with the Moderate Resolution Imaging Spectroradiometer (MODIS Terra/Aqua level 3 monthly mean AOD dataset for the same time period. While the spatial distribution and seasonal variability of CALIPSO AOD is generally consistent with that of MODIS, CALIPSO is overall lower than MODIS as MODIS has higher frequency than CALIPSO for most bins of AOD. The correlation between MODIS and CALIPSO is better over ocean than over land. We focused on four regions that have large systematic differences: two over dust regions (the Sahara and Northwest China and two over biomass burning regions (South Africa and South America. It is found that CALIPSO AOD is significantly lower than MODIS AOD over dust regions during the whole time period, with a maximum difference of 0.3 over the Saharan region and 0.25 over Northwest China. For biomass burning regions, CALIPSO AOD is significantly higher than MODIS AOD over South Africa, with a maximum difference of 0.25. Additionally CALIPSO AOD is slightly higher than MODIS AOD over South America for most of the time period, with a few exceptions in 2006, 2007, and 2010, when biomass burning is significantly stronger than during other years. We analyzed the impact of the satellite spatial and temporal sampling issue by using level 2 CALIPSO and MODIS products, and these systematic differences can still be found. The results of this study indicate that systematic differences of CALIPSO relative to MODIS are closely associated with aerosol types, which vary by location and season. Large differences over dust and biomass burning regions may suggest that assumptions made in satellite

  9. Are there Differences in the Mandibular Morphometry in Patients who are Candidates for Orthognathic Surgery? Part 2: Influences of Gender

    OpenAIRE

    Olate, S; Pozzer, L; Sawazaki, R; Asprino, L; de Moraes, M

    2009-01-01

    Individual facial features are to be associated with genetic and environmental influences, it is possible to identify clear differences between the facial patterns of men and women, where dentofacial deformities (FDA) will influence the surgical indications, surgical techniques and the final aesthetic results. We performed a cohort study with patients who consulted for orthognathic surgery between 2002 and 2008 in the Division of Oral and Maxillofacial Surgery of the FOP-UNICAMP. Examined pan...

  10. THE CHANGES OF IL-1β AND IL-6 LEVEL AT DIFFERENT ALTITUDE AND THEIR SIGNIFICANCE

    Institute of Scientific and Technical Information of China (English)

    Jia Mian; Geng Paili; Zhu Haihong; Wu Hongfu

    2006-01-01

    Objective To investigate the changes of the concentration of interkeukine β 1(IL-1β) and Interleukine 6(IL-6) in the serum of the people who live in the different altitude, and try to find the relation between the cytokines (CK) and the hypoxia adaptation and some diseases caused by hypoxia. Methods Using enzyme linked immunoabsorbent assay (ELISA) to detect the level of the concentration of IL-1β and IL-6 in the serum. Results The concentration of IL-1β showed significant increase in values (P<0.05) at 4050m. IL-6 in same altitude showed obvious changes as well (P<0.05). Conclusion The results showed that the concentration of IL-1β and IL-6 have significant changes in the serum. This means that they may be involved in the process of the adaptation and some sickness because of hypoxia.

  11. Small airway function changes and its clinical significance of asthma patients in different clinical phases

    Institute of Scientific and Technical Information of China (English)

    Yan-Hui Zhou; Jun-Ti Lu

    2016-01-01

    Objective:To observe the small airways function changes of asthmatic patients in different clinical phases and to discuss its clinical significance.Methods:A total of 127 patients diagnosed as asthma were selected randomly and pulmonary function (PF) of them was determined by conventional method. Then they were divided into A, B and C group based on PF results. All 34 patients in A group suffered from acute asthma attack for the first time. All 93 patients in B group had been diagnosed as asthma but in remission phase. C Group was regarded as Control group with 20 healthy volunteers. Then FEV1, FEF50%, FEF75% levels of patients in each group were analyzed, and FEV1, FEF75% and FEF50% levels of patients in each group were compared after bronchial dilation test.Results:It was found that most patients in group A and B had abnormal small airways function, and their small airways function was significantly different compared with that of group C (P<0.01). In addition, except for group C, FEF75%, FEF50% levels in A and B group were improved more significantly than FEV1 levels (P<0.01).Conclusions:Asthma patients in acute phase all have abnormal small airways function. Most asthma patients in remission phase also have abnormal small airways function. After bronchial dilation test, whether patients in acute phase or in remission phase, major and small airways function of them are improved, but improvement of small airways function is weaker than that of major airways. This indicates that asthma respiratory tract symptoms in different phases exists all the time and so therapeutic process is needed to perform step by step.

  12. Factors correlating with significant differences between X-ray structures of myoglobin

    Energy Technology Data Exchange (ETDEWEB)

    Rashin, Alexander A., E-mail: alexander-rashin@hotmail.com [BioChemComp Inc., 543 Sagamore Avenue, Teaneck, NJ 07666 (United States); Iowa State University, 112 Office and Lab Bldg, Ames, IA 50011-3020 (United States); Domagalski, Marcin J. [University of Virginia, 1340 Jefferson Park Avenue, Jordan Hall, Room 4223, Charlottesville, VA 22908 (United States); Zimmermann, Michael T. [Iowa State University, 112 Office and Lab Bldg, Ames, IA 50011-3020 (United States); Minor, Wladek [University of Virginia, 1340 Jefferson Park Avenue, Jordan Hall, Room 4223, Charlottesville, VA 22908 (United States); Chruszcz, Maksymilian [University of Virginia, 1340 Jefferson Park Avenue, Jordan Hall, Room 4223, Charlottesville, VA 22908 (United States); University of South Carolina, 631 Sumter Street, Columbia, SC 29208 (United States); Jernigan, Robert L. [Iowa State University, 112 Office and Lab Bldg, Ames, IA 50011-3020 (United States); BioChemComp Inc., 543 Sagamore Avenue, Teaneck, NJ 07666 (United States)

    2014-02-01

    Conformational differences between myoglobin structures are studied. Most structural differences in whale myoglobin beyond the uncertainty threshold can be correlated with a few specific structural factors. There are always exceptions and a search for additional factors is needed. The results might have serious implications for biological insights from conformational differences. Validation of general ideas about the origins of conformational differences in proteins is critical in order to arrive at meaningful functional insights. Here, principal component analysis (PCA) and distance difference matrices are used to validate some such ideas about the conformational differences between 291 myoglobin structures from sperm whale, horse and pig. Almost all of the horse and pig structures form compact PCA clusters with only minor coordinate differences and outliers that are easily explained. The 222 whale structures form a few dense clusters with multiple outliers. A few whale outliers with a prominent distortion of the GH loop are very similar to the cluster of horse structures, which all have a similar GH-loop distortion apparently owing to intermolecular crystal lattice hydrogen bonds to the GH loop from residues near the distal histidine His64. The variations of the GH-loop coordinates in the whale structures are likely to be owing to the observed alternative intermolecular crystal lattice bond, with the change to the GH loop distorting bonds correlated with the binding of specific ‘unusual’ ligands. Such an alternative intermolecular bond is not observed in horse myoglobins, obliterating any correlation with the ligands. Intermolecular bonds do not usually cause significant coordinate differences and cannot be validated as their universal cause. Most of the native-like whale myoglobin structure outliers can be correlated with a few specific factors. However, these factors do not always lead to coordinate differences beyond the previously determined uncertainty

  13. [Assessment of pain relief in patients receiving different variants of multimodal analgesia after major gynecological surgery].

    Science.gov (United States)

    Timerbaev, V H; Smimova, O V; Genov, P G; Olejnikova, O N; Rebrova, O Yu

    2014-01-01

    The major gynecology surgery generally results in severe postoperative pain. Currently multimodal analgesia concept is widely used for the aim of postoperative pain relief optimization. According to this theory it is worth using the medication with different mechanism in order to increase analgesia qualify, decrease analgesic consumption and avoid adverse reaction. Unfortunately the surveys recently conducted have been pointed out the postoperative analgesia quality is still insufficient despite of using the concept mentioned above. One way to solve the problem is appearing in daily practice nefopam--centrally acting non-opioid analgesic that inhibits reuptake of serotonin, norepinephrine, and dopamine and also mitigates glutamatergic neurotransmission. In this trial we tried to assess the postoperative daily used analgesia quality and potency of preemptive multimodal analgesia model consisted of nefopam, ketoprofen, paracetamol and morphine.

  14. Different Supplementation Regimes to Treat Perioperative Vitamin B12 Deficiencies in Bariatric Surgery: a Systematic Review.

    Science.gov (United States)

    Smelt, H J M; Pouwels, S; Smulders, J F

    2017-01-01

    Vitamin B12 dosage in multivitamin supplementation in the current literature is quite variable. There is no consensus about the optimal treatment of vitamin B12 deficiency. A systematic literature search on different supplementation regimes to treat perioperative vitamin B12 deficiencies in bariatric surgery was performed. The methodological quality of ten included studies was rated using the Newcastle Ottawa scale and ranged from moderate to good. The agreement between the reviewers was assessed with a Cohen's kappa (0.69). The current literature suggests that 350 μg oral vitamin B12 is the appropriate dose to correct low vitamin B12 levels in many patients. Further research must focus on a better diagnosis of a vitamin B12 deficiency, the optimal dose vitamin B12 supplementation, and clinical relevance next to biochemical data.

  15. Process of Judging Significant Modifications for Different Transportation Systems compared to the Approach for Nuclear Installations

    Directory of Open Access Journals (Sweden)

    Nicolas Petrek

    2015-12-01

    Full Text Available The implementation of the CSM regulation by the European Commission in 2009 which harmonizes the risk assessment process and introduces a rather new concept of judging changes within the European railway industry. This circumstance has risen the question how other technology sectors handle the aspect of modifications and alterations. The paper discusses the approaches for judging the significance of modifications within the three transport sectors of European railways, aviation and maritime transportation and the procedure which is used in the area of nuclear safety. We will outline the similarities and differences between these four methods and discuss the underlying reasons. Finally, we will take into account the role of the European legislator and the fundamental idea of a harmonization of the different approaches.

  16. The different functions and clinical significances of caveolin-1 in human adenocarcinoma and squamous cell carcinoma

    Science.gov (United States)

    Fu, Pin; Chen, Fuchun; Pan, Qi; Zhao, Xianda; Zhao, Chen; Cho, William Chi-Shing; Chen, Honglei

    2017-01-01

    Caveolin-1 (Cav-1), a major structural protein of caveolae, is an integral membrane protein which plays an important role in the progression of carcinoma. However, whether Cav-1 acts as a tumor promoter or a tumor suppressor still remains controversial. For example, the tumor-promoting function of Cav-1 has been found in renal cancer, prostate cancer, tongue squamous cell carcinoma (SCC), lung SCC and bladder SCC. In contrast, Cav-1 also plays an inhibitory role in esophagus adenocarcinoma, lung adenocarcinoma and cutaneous SCC. The role of Cav-1 is still controversial in thyroid cancer, hepatocellular carcinoma, gastric adenocarcinoma, colon adenocarcinoma, breast cancer, pancreas cancer, oral SCC, laryngeal SCC, head and neck SCC, esophageal SCC and cervical SCC. Besides, it has been reported that the loss of stromal Cav-1 might predict poor prognosis in breast cancer, gastric cancer, pancreas cancer, prostate cancer, oral SCC and esophageal SCC. However, the accumulation of stromal Cav-1 has been found to be promoted by the progression of tongue SCC. Taken together, Cav-1 seems playing a different role in different cancer subtypes even of the same organ, as well as acting differently in the same cancer subtype of different organs. Thus, we hereby explore the functions of Cav-1 in human adenocarcinoma and SCC from the perspective of clinical significances and pathogenesis. We envision that novel targets may come with the further investigation of Cav-1 in carcinogenesis. PMID:28243118

  17. A graph of dark energy significance on different spatial and mass scales

    CERN Document Server

    Teerikorpi, P; Nurmi, P; Chernin, A D; Einasto, M; Valtonen, M; Byrd, G

    2015-01-01

    The current cosmological paradigm sees the formation and evolution of the cosmic large-scale structure as governed by the gravitational attraction of the Dark Matter (DM) and the repulsion of the Dark Energy (DE). We characterize the relative importance of uniform and constant dark energy, as given by the Lambda term in the standard LCDM cosmology, in galaxy systems of different scales, from groups to superclusters. An instructive "Lambda significance graph" is introduced where the matter-DE density ratio /rho_Lambda for different galaxy systems is plotted against the radius R. This presents gravitation and DE dominated regions and shows directly the zero velocity radius, the zero-gravity radius, and the Einstein-Straus radius for any fixed value of mass. Example galaxy groups and clusters from the local universe illustrate the use of the Lambda significance graph. These are generally located deep in the gravity-dominated region /rho_Lambda > 2, being virialized. Extended clusters and main bodies of superclus...

  18. Levels of vitamin C In the blood plasma patients treated with coronary artery bypass grafting increases significantly after surgery.

    Science.gov (United States)

    Kleszczewski, Tomasz; Modzelewska, Beata; Lisowska, Anna; Buzun, Leszek; Kleszczewska, Ewa

    2017-01-01

    One strong risk factor of coronary artery disease (CAD), which affects the levels of vitamin C in the blood is cigarette smoking. The supplementary effects of coronary artery bypass grafting (CABG) is smoking cessation by patients. Therefore, the aim of this study was to examine the level of vitamin C in the blood plasma one day before and one month after CABG. Human blood were collected from 20 patients (men); 1day before and 1 month after CABG. All patients were smoker and after CABG they declared their not smoking. The concentration of vitamin C in the blood plasma was assayed by FIA method with spectrophotometric detection. The mean value of the vitamin C concentration 1day before CABG was 12.36±2.84μmol/L (mean±SD), 1 month after CABG 40.07±10.95μmol/L (mean±SD). The average increase in the concentration of vitamin C was 3.27±0.73 times (mean±SD) and showed significant positive correlations (Pearson r=0.657, p=0.002). It should be consider incorporating the recommendations of preoperative smoking cessation for at least one month prior to CABG and/or additional supplementation. In addition it would be relevant to monitor the level of vitamin C in the patients' blood in the preoperative period.

  19. Evaluating the different laser fragmentation patterns used in laser cataract surgeries in terms of effective phacoemulsification time and power

    Directory of Open Access Journals (Sweden)

    Huseynova T

    2015-11-01

    Full Text Available Tukezban Huseynova,1 Mariko Mita,2 Christine Carole C Corpuz,1 Yuko Sotoyama,1 Minoru Tomita2,3 1Shinagawa LASIK Center, Tokyo, Japan; 2Tomita Minoru Eye Clinic Ginza, Tokyo, Japan; 3Wenzhou Medical College, Wenzhou, People’s Republic of China Purpose: To evaluate the effects of the different fragmentation patterns for the lens nucleus in terms of the effective phacoemulsification time (EPT and power. Setting: Shinagawa LASIK Center, Tokyo, Japan. Design: Comparison study. Methods: Seventy-one eyes of 71 patients had preoperative lens opacity grading based on the Emery-Little Classification (Grade 1 and Grade 2. Eyes underwent femtosecond laser-assisted cataract surgery (Catalys™ Precision Laser System, for capsulotomy and lens fragmentation. For the lens fragmentation, either the quadrants softened (Quadrant or the quadrants complete (Complete pattern was used. The mean EPT and phacoemulsification (phaco power for each cutting pattern of Grades 1 and 2 cataracts were evaluated. Results: The mean EPT was 28.96 seconds in the Quadrant Group and 16.31 seconds in the Complete Group (P=0.006. The mean phaco power was 8.07% in the Quadrant Group and 4.77% in the Complete Group (P=0.0002. Comparing the Quadrant and Complete Groups of Grade 1 cataract showed no significant difference in EPT (P=0.16, but showed a significant difference in phaco power (P=0.033. Comparing the Quadrant and Complete patterns of Grade 2 cataract showed significant differences in both EPT (P=0.012 and phaco power (P=0.003. Using the Complete pattern showed a 44.7% reduction in EPT and a 40.9% reduction in phaco power when compared to the Quadrant Group. Conclusion: Using the smaller fragmentation pattern in femtosecond laser cataract surgery, the phaco time and power were reduced significantly when compared to the procedure with the larger fragmentation pattern. Keywords: effective phacoemulsification time (EPT, complete and quadrant fragmentation pattern

  20. Violence-related Versus Terror-related Stabbings: Significant Differences in Injury Characteristics.

    Science.gov (United States)

    Rozenfeld, Michael; Givon, Adi; Peleg, Kobi

    2017-01-24

    To demonstrate the gap between injury epidemiology of terror-related stabbings (TRS) and non-terror-related intentional stabbings. Terror attacks with sharp instruments have multiplied recently, with many victims of these incidents presented to hospitals with penetrating injuries. Because most practical experience of surgeons with intentional stabbing injuries comes from treating victims of interpersonal violence, potential gaps in knowledge may exist if injuries from TRS significantly differ from interpersonal stabbings (IPS). A retrospective study of 1615 patients from intentional stabbing events recorded in the Israeli National Trauma Registry during the period of "Knife Intifada" (January 2013-March 2016). All stabbings were divided into TRS and IPS. The 2 categories were compared in terms of sustained injuries, utilization of hospital resources, and clinical outcomes. TRS patients were older, comprised more females and were ethnically homogenous. Most IPS incidents happened on weekdays and at night hours, whereas TRS events peaked midweek during morning and afternoon hours. TRS patients had more injuries of head, face, and neck, and severe head and neck injuries. IPS patients had more abdomen injuries; however, respective injuries in the TRS group were more severe. Greater injury severity of the TRS patients reflected on their higher hospital resources utilization and greater in-hospital mortality. Victims of terror stabbings are profoundly different in their characteristics, sustain injuries of a different profile and greater severity, require more hospital resources, and have worse off clinical outcomes, emphasizing the need of the healthcare systems to adjust itself appropriately to deal successfully with future terror attacks.

  1. Preparing for Surgery

    Science.gov (United States)

    ... Events Advocacy For Patients About ACOG Preparing for Surgery Home For Patients Search FAQs Preparing for Surgery ... Surgery FAQ080, August 2011 PDF Format Preparing for Surgery Gynecologic Problems What is the difference between outpatient ...

  2. Preparing for Surgery

    Science.gov (United States)

    ... Events Advocacy For Patients About ACOG Preparing for Surgery Home For Patients Search FAQs Preparing for Surgery ... Surgery FAQ080, August 2011 PDF Format Preparing for Surgery Gynecologic Problems What is the difference between outpatient ...

  3. Efficiency of different techniques of ablation of longstanding persistent atrial fibrillation during coronary bypass surgery

    Directory of Open Access Journals (Sweden)

    А. М. Чернявский

    2016-01-01

    Full Text Available Objective. The purpose of this prospective, randomized, single-center, uncontrolled, open study was to assess the efficiency of surgical treatment of the most common worldwide disease of the cardiovascular system – coronary heart disease (CHD in combination with atrial fibrillation (AF. Methods. Different techniques of AF ablation in patients with coronary artery disease during coronary bypass surgery were analyzed. 98 patients with longstanding persistent AF were randomized into three groups: PVI+CABG (n = 31 group underwent isolation of the pulmonary veins, the CABG+MM group (n = 37 received a modified mini-MAZE procedure (isolation of pulmonary veins in combination with left isthmus ablation and formation of an ablation line on the roof of the left atrium and CABG with anatomical ablation of ganglionated plexi zones was performed for the CABG+GP group patients (n = 30. Results. It was found out that in patients with coronary artery disease and longstanding persistent AF, only radiofrequency fragmentation of the left atrium performed during CABG surgery can yield satisfactory results in the long term, with efficiency running up to 48.65%. Predictors of AF return in the patients with longstanding persistent AF are: the size of the left atrium exceeding 6.5 cm (OR 1.18, CI 1.01–1.75; p = 0.043 and a long (over 10 years AF history (OR 1.07, CI 0.23–5.03; p = 0.038. Conclusion. Ganglionated plexi ablation performed simultaneously with CABG in patients with long standing persistent AF has a low efficiency in the long term (33.3% and cannot be an independent method of treatment of this form of AF.

  4. Intrapartum caesarean rates differ significantly between ethnic groups--relationship to induction.

    LENUS (Irish Health Repository)

    Ismail, Khadijah I

    2012-01-31

    OBJECTIVE: Given international variation in obstetric practices and outcomes, comparison of labour outcomes in different ethnic groups could provide important information regarding the underlying reasons for rising caesarean delivery rates. Increasing numbers of women from Eastern European countries are now delivering in Irish maternity hospitals. We compared labour outcomes between Irish and Eastern European (EE) women in a large tertiary referral center. STUDY DESIGN: This was a prospective consecutive cohort study encompassing a single calendar year. The cohort comprised 5550 Irish and 867 EE women delivered in a single institution in 2009. Women who had multiple pregnancies, breech presentation, and elective or pre-labour caesarean sections (CS) were excluded. Data obtained from birth registers included maternal age, nationality, parity, gestation, onset of labour, mode of delivery and birth weight. RESULTS: The overall intrapartum CS rate was 11.4% and was significantly higher in Irish compared to EE women (11.8% vs. 8.8%; p=0.008). The proportion of primiparas was lower in Irish compared to EE women (44.8% vs. 63.6%; p<0.0001). The intrapartum CS rate was almost doubled in Irish compared to EE primiparas (20.7% vs. 11.0%; p<0.0001). Analysis of primiparas according to labour onset revealed a higher intrapartum CS rate in Irish primiparas in both spontaneous (13.5% vs. 7.2%; p<0.0001) and induced labour (29.5% vs. 19.3%; p=0.005). Irish women were older with 19.7% of primiparas aged more than 35, compared to 1.6% of EE women (p<0.0001). The primigravid CS rate in Irish women was significantly higher in women aged 35 years or older compared women aged less than 35 (30.6% vs. 18.3%; p<0.0001) consistent in both spontaneous and induced labour. The primiparous induction rate was 45.4% in Irish women compared to 32% in EE women, and more Irish women were induced before 41 weeks gestation. CONCLUSION: The results highlight that primigravid intrapartum CS rates were

  5. Spore populations among bulk tank raw milk and dairy powders are significantly different.

    Science.gov (United States)

    Miller, Rachel A; Kent, David J; Watterson, Matthew J; Boor, Kathryn J; Martin, Nicole H; Wiedmann, Martin

    2015-12-01

    To accommodate stringent spore limits mandated for the export of dairy powders, a more thorough understanding of the spore species present will be necessary to develop prospective strategies to identify and reduce sources (i.e., raw materials or in-plant) of contamination. We characterized 1,523 spore isolates obtained from bulk tank raw milk (n=33 farms) and samples collected from 4 different dairy powder-processing plants producing acid whey, nonfat dry milk, sweet whey, or whey protein concentrate 80. The spores isolated comprised 12 genera, at least 44 species, and 216 rpoB allelic types. Bacillus and Geobacillus represented the most commonly isolated spore genera (approximately 68.9 and 12.1%, respectively, of all spore isolates). Whereas Bacillus licheniformis was isolated from samples collected from all plants and farms, Geobacillus spp. were isolated from samples from 3 out of 4 plants and just 1 out of 33 farms. We found significant differences between the spore population isolated from bulk tank raw milk and those isolated from dairy powder plant samples, except samples from the plant producing acid whey. A comparison of spore species isolated from raw materials and finished powders showed that although certain species, such as B. licheniformis, were found in both raw and finished product samples, other species, such as Geobacillus spp. and Anoxybacillus spp., were more frequently isolated from finished powders. Importantly, we found that 8 out of 12 genera were isolated from at least 2 different spore count methods, suggesting that some spore count methods may provide redundant information if used in parallel. Together, our results suggest that (1) Bacillus and Geobacillus are the predominant spore contaminants in a variety of dairy powders, implying that future research efforts targeted at elucidating approaches to reduce levels of spores in dairy powders should focus on controlling levels of spore isolates from these genera; and (2) the spore

  6. Field Dependence/Independence Cognitive Styles: Are They Significant At Different Levels Of Vocabulary Knowledge?

    Directory of Open Access Journals (Sweden)

    Mohammad Rostampour

    2014-01-01

    Full Text Available Cognitive styles influence the performance of language learners and can predict their success in the process of language learning. Considering field dependence/independence cognitive styles, this study aims at determining if they are significant in English vocabulary knowledge. A number of EFL university students took part in the study. The investigation was done through using Vocabulary Size Test (VST (Nation, 2007 and the Group Embedded Figures Test (GEFT (Witkin, Oltman, Raskin, and Karp, 1971. Using the Vocabulary Size Test (VST, the participants were divided into three groups of high, mid, and low. Moreover, with respect to the Group Embedded Figures Test (GEFT, they were divided into two groups, field dependents and field independents. Mean score comparison revealed there was a credible and meaningful relationship between field dependence/independence cognitive styles and total vocabulary knowledge. It was also indicated there was a significant relationship between field dependence/independence cognitive styles and vocabulary knowledge in the high and mid groups. Finally, based on the findings, teachers should take learners’ individual differences into consideration so that they could adopt and apply teaching methods in line with the learners’ various cognitive styles.   

  7. No difference found in time to publication by statistical significance of trial results: a methodological review

    Science.gov (United States)

    Jefferson, L; Cooper, E; Hewitt, C; Torgerson, T; Cook, L; Tharmanathan, P; Cockayne, S; Torgerson, D

    2016-01-01

    Objective Time-lag from study completion to publication is a potential source of publication bias in randomised controlled trials. This study sought to update the evidence base by identifying the effect of the statistical significance of research findings on time to publication of trial results. Design Literature searches were carried out in four general medical journals from June 2013 to June 2014 inclusive (BMJ, JAMA, the Lancet and the New England Journal of Medicine). Setting Methodological review of four general medical journals. Participants Original research articles presenting the primary analyses from phase 2, 3 and 4 parallel-group randomised controlled trials were included. Main outcome measures Time from trial completion to publication. Results The median time from trial completion to publication was 431 days (n = 208, interquartile range 278–618). A multivariable adjusted Cox model found no statistically significant difference in time to publication for trials reporting positive or negative results (hazard ratio: 0.86, 95% CI 0.64 to 1.16, p = 0.32). Conclusion In contrast to previous studies, this review did not demonstrate the presence of time-lag bias in time to publication. This may be a result of these articles being published in four high-impact general medical journals that may be more inclined to publish rapidly, whatever the findings. Further research is needed to explore the presence of time-lag bias in lower quality studies and lower impact journals. PMID:27757242

  8. Detection of significant differences between absorption spectra of neutral helium and low temperature photoionized helium plasmas

    Energy Technology Data Exchange (ETDEWEB)

    Bartnik, A.; Wachulak, P.; Fiedorowicz, H.; Fok, T.; Jarocki, R.; Szczurek, M. [Institute of Optoelectronics, Military University of Technology, Kaliskiego 2, 00-908 Warsaw (Poland)

    2013-11-15

    In this work, spectral investigations of photoionized He plasmas were performed. The photoionized plasmas were created by irradiation of helium stream, with intense pulses from laser-plasma extreme ultraviolet (EUV) source. The EUV source was based on a double-stream Xe/Ne gas-puff target irradiated with 10 ns/10 J Nd:YAG laser pulses. The most intense emission from the source spanned a relatively narrow spectral region below 20 nm, however, spectrally integrated intensity at longer wavelengths was also significant. The EUV radiation was focused onto a gas stream, injected into a vacuum chamber synchronously with the EUV pulse. The long-wavelength part of the EUV radiation was used for backlighting of the photoionized plasmas to obtain absorption spectra. Both emission and absorption spectra in the EUV range were investigated. Significant differences between absorption spectra acquired for neutral helium and low temperature photoionized plasmas were demonstrated for the first time. Strong increase of intensities and spectral widths of absorption lines, together with a red shift of the K-edge, was shown.

  9. Seed metabolomic study reveals significant metabolite variations and correlations among different soybean cultivars

    Institute of Scientific and Technical Information of China (English)

    Hong Lin; Jun Rao; Jianxin Shi; Chaoyang Hu; Fang Cheng; Zoe AWilson; Dabing Zhang; Sheng Quan

    2014-01-01

    Soybean [Glycine max (L.) Merr.] is one of the world’s major crops, and soybean seeds are a rich and important resource for proteins and oils. While “omics”studies, such as genomics, transcriptomics, and proteomics, have been widely applied in soybean molecular research, fewer metabolomic studies have been conducted for large-scale detection of low molecular weight metabolites, especial y in soybean seeds. In this study, we investigated the seed metabolomes of 29 common soybean cultivars through combined gas chromatography-mass spectrometry and ultra-performance liquid chromatography-tandem mass spectrometry. One hundred sixty-nine named metabolites were identified and subsequently used to construct a metabolic network of mature soybean seed. Among the 169 detected metabolites, 104 were found to be significantly variable in their levels across tested cultivars. Metabolite markers that could be used to distinguish genetical y related soybean cultivars were also identified, and metabolite-metabolite correlation analysis revealed some significant associations within the same or among different metabolite groups. Findings from this work may potentially provide the basis for further studies on both soybean seed metabolism and metabolic engineering to improve soybean seed quality and yield.

  10. Impact of bariatric surgery on carotid artery inflammation and the metabolic activity in different adipose tissues.

    Science.gov (United States)

    Bucerius, Jan; Vijgen, Guy H E J; Brans, Boudewijn; Bouvy, Nicole D; Bauwens, Matthias; Rudd, James H F; Havekes, Bas; Fayad, Zahi A; van Marken Lichtenbelt, Wouter D; Mottaghy, Felix M

    2015-05-01

    In this study, we unravel a molecular imaging marker correlated with the known reduction of cardiovascular events (most commonly related to vulnerable plaques) in morbidly obese patients after bariatric surgery (BaS).We prospectively imaged 10 morbidly obese subjects with F-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography before and 1 year after BaS. F-FDG uptake-which is enhanced in inflamed, atherosclerotic vessels and in metabolically active adipose tissues-was quantified in the carotids, pericardial adipose tissue (PAT), visceral adipose tissue (VAT), as well as brown adipose tissue (BAT). The degree of carotid inflammation was compared to lean and overweight controls.Carotid inflammation significantly declined leading to an F-FDG uptake comparable to the 2 control groups. Metabolic activity significantly decreased in PAT and VAT and increased in BAT.BaS leads to a normalization of carotid artery inflammation and a beneficial impact on the metabolic activity in PAT, VAT, and BAT that is related to the metabolic syndrome observed in this patient group.

  11. Statistically significant faunal differences among Middle Ordovician age, Chickamauga Group bryozoan bioherms, central Alabama

    Energy Technology Data Exchange (ETDEWEB)

    Crow, C.J.

    1985-01-01

    Middle Ordovician age Chickamauga Group carbonates crop out along the Birmingham and Murphrees Valley anticlines in central Alabama. The macrofossil contents on exposed surfaces of seven bioherms have been counted to determine their various paleontologic characteristics. Twelve groups of organisms are present in these bioherms. Dominant organisms include bryozoans, algae, brachiopods, sponges, pelmatozoans, stromatoporoids and corals. Minor accessory fauna include predators, scavengers and grazers such as gastropods, ostracods, trilobites, cephalopods and pelecypods. Vertical and horizontal niche zonation has been detected for some of the bioherm dwelling fauna. No one bioherm of those studied exhibits all 12 groups of organisms; rather, individual bioherms display various subsets of the total diversity. Statistical treatment (G-test) of the diversity data indicates a lack of statistical homogeneity of the bioherms, both within and between localities. Between-locality population heterogeneity can be ascribed to differences in biologic responses to such gross environmental factors as water depth and clarity, and energy levels. At any one locality, gross aspects of the paleoenvironments are assumed to have been more uniform. Significant differences among bioherms at any one locality may have resulted from patchy distribution of species populations, differential preservation and other factors.

  12. Growth patterns and dynamics of mud cracks at different diagenetic stages and its geological significance

    Institute of Scientific and Technical Information of China (English)

    Zhen-yu ZHAO; Yan-ru GUO; Yan WANG; Hong LIU; Qing ZHANG

    2014-01-01

    This paper discusses the growth stages, spatial structures, quantitative fitting relationships among various parameters, growth patterns and influencing factors of mud cracks by field survey, core observation and SEM analysis. The study shows that:(1) Mud crack growth can go through three stages, i.e. the syndiagenetic stage, the burial diagenetic stage (including early diagenetic stage, middle-late diagenetic stage) and the epidiagenetic stage. (2) Quantitative fitting relationships among various parameters allow a great significance to describe the spatial structure, the regional distribution and the growth environment of mud cracks. (3) Mud crack growth has three models, such as the unilateral growth model including the linear growth pattern, the curvilinear growth pattern and the bifurcation growth pattern, the multilateral growth model including the intersectional growth pattern, the join growth pattern and the dispersed growth pattern, and the mixed growth model including the combination of any patterns listed above. (4) Modern mud crack growth usually undergoes four stages. Sand beds in sand-mud rhythmic strata can play a lubricative role on crack growth and provide enough sandy deposits for filling cracks. (5) Mud crack growth usually produces bifurcation and bifurcation angles which are mostly 120° or 90° that are related to sediment heterogeneity and released energy. (6) Factors affecting mud crack growth cover many aspects: clay content and salinity can control the number of mud cracks in different areas;terrain can control mud crack morphology;and different sedimentary cycles can control the growth patterns and filling models of mud cracks.

  13. Comparison of AOD between CALIPSO and MODIS: significant differences over major dust and biomass burning regions

    Directory of Open Access Journals (Sweden)

    X. Ma

    2012-11-01

    Full Text Available Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observations (CALIPSO provide, for the first time, global vertical profiles of aerosol optical properties, but further research is needed to evaluate the CALIPSO products. In this study, we employed about 6 yr (2006–2011 of CALIPSO level-3 monthly mean gridded aerosol optical depth (AOD products (daytime and nighttime, for cloud free conditions, to compare with the MODIS Terra/Aqua level-3 monthly mean AOD dataset for the same time period. While the spatial distribution and seasonal variability of CALIPSO AOD is generally consistent with that of MODIS, CALIPSO is overall lower than MODIS as much more of the CALIPSO data is smaller than 0.1, while more of the MODIS data is greater than 0.1. We will focus on four regions that have large systematic differences: two over dust regions (the Sahara and Northwest China and two over biomass burning regions (South Africa and South America. It is found that CALIPSO AOD is significantly lower than MODIS AOD over dust regions during the whole time period, with a maximum low bias of 0.3 over the Saharan region, and 0.25 over Northwest China. For biomass burning regions, CALIPSO AOD is significantly higher than MODIS AOD over South Africa, with a maximum high bias of 0.25. Additionally CALIPSO AOD is slightly higher than MODIS AOD over South America for most of the time period, with a few exceptions in 2006, 2007, and 2010, when biomass burning is significantly stronger than during other years. The results in this study indicate that systematic biases of CALIPSO relative to MODIS are closely associated with aerosol types, which vary by location and season. Large differences over dust and biomass burning regions may suggest that assumptions made in satellite retrievals, such as the assumed lidar ratios for CALIPSO retrievals over dust and biomass burning regions, or the surface reflectance information and/or the aerosol model utilized by MODIS algorithm

  14. Cardiopulmonary bypass during cardiac surgery modulates systemic inflammation by affecting different steps of the leukocyte recruitment cascade.

    Directory of Open Access Journals (Sweden)

    Jan Rossaint

    Full Text Available BACKGROUND: It is known that the use of a cardiopulmonary bypass (CPB during cardiac surgery leads to leukocyte activation and may, among other causes, induce organ dysfunction due to increased leukocyte recruitment into different organs. Leukocyte extravasation occurs in a cascade-like fashion, including capturing, rolling, adhesion, and transmigration. However, the molecular mechanisms of increased leukocyte recruitment caused by CPB are not known. This clinical study was undertaken in order to investigate which steps of the leukocyte recruitment cascade are affected by the systemic inflammation during CPB. METHODS: We investigated the effects of CPB on the different steps of the leukocyte recruitment cascade in whole blood from healthy volunteers (n = 9 and patients undergoing cardiac surgery with the use of cardiopulmonary bypass (n = 7 or in off-pump coronary artery bypass-technique (OPCAB, n = 9 by using flow chamber experiments, transmigration assays, and biochemical analysis. RESULTS: CPB abrogated selectin-induced slow leukocyte rolling on E-selectin/ICAM-1 and P-selectin/ICAM-1. In contrast, chemokine-induced arrest and transmigration was significantly increased by CPB. Mechanistically, the abolishment of slow leukocyte rolling was due to disturbances in intracellular signaling with reduced phosphorylation of phospholipase C (PLC γ2, Akt, and p38 MAP kinase. Furthermore, CPB induced an elevated transmigration which was caused by upregulation of Mac-1 on neutrophils. CONCLUSION: These data suggest that CPB abrogates selectin-mediated slow leukocyte rolling by disturbing intracellular signaling, but that the clinically observed increased leukocyte recruitment caused by CPB is due to increased chemokine-induced arrest and transmigration. A better understanding of the underlying molecular mechanisms causing systemic inflammation after CPB may aid in the development of new therapeutic approaches.

  15. Study of the patency of different peritoneal drains used prophylactically in bariatric surgery

    Institute of Scientific and Technical Information of China (English)

    Wilson Salgado Júnior; Marcelo Martins Macedo Neto; José Sebastiao dos Santos; Ajith Kumar Sakarankutty; Reginaldo Ceneviva; Orlando de Castro e Silva Jr

    2009-01-01

    AIM: To compare the performance of different types of abdominal drains used in bariatric surgery. METHODS: A vertical banded Roux-en-Y gastric bypass was performed in 33 morbidly obese patients. Drainage of the peritoneal cavity was performed in each case using three different types of drain selected in a randomized manner: a latex tubular drain, a Watterman tubulolaminar drain, and a silicone channeled drain. Drain permeability, contamination of the drained fluid, ease of handling, and patient discomfort were evaluated postoperatively over a period of 7 d. RESULTS: The patients with the silicone channeled drain had larger volumes of drainage compared to patients with tubular and tubulolaminar drains between the third and seventh postoperative days. In addition, a lower incidence of discomfort and of contamination with bacteria of a more pathogenic profile was observed in the patients with the silicone channeled drain.CONCLUSION: The silicone channeled drain was more comfortable and had less chance of occlusion, which is important in the detection of delayed dehiscence.

  16. Clinical progress and its significance in current apical surgery%根尖手术的临床进展和意义

    Institute of Scientific and Technical Information of China (English)

    王霄

    2012-01-01

    Enormous progress has been made and the success of treatment has been improved in apical surgery by using the surgical microscopy, ultrasound equipment, and new materials in recent years. The purpose of this article is to review the clinical progress and significance in current concepts, operating equipments, surgical techniques, root-end filling materials, and the application of the guide tissue regeneration in apical surgery.%近来,口腔显微镜、超声器械和新材料等应用于根管外科领域,给根尖手术带来了巨大的变化,提高了手术的成功率.本文就当前的根尖手术现状、手术器械、手术技术、根尖倒充填材料和引导组织再生术在根尖手术中的应用等临床进展和意义作一综述.

  17. Providing preoperative information for children undergoing surgery: a randomized study testing different types of educational material to reduce children's preoperative worries.

    Science.gov (United States)

    Fernandes, S C; Arriaga, P; Esteves, F

    2014-12-01

    This study developed three types of educational preoperative materials and examined their efficacy in preparing children for surgery by analysing children's preoperative worries and parental anxiety. The sample was recruited from three hospitals in Lisbon and consisted of 125 children, aged 8-12 years, scheduled to undergo outpatient surgery. The participants were randomly assigned to one of the seven independent conditions that were combined into the following three main groups: an experimental group, which received educational materials with information about surgery and hospitalization (a board game, a video or a booklet); a comparison group, which received entertaining material with the same format type; and a control group, which did not receive any material. Children's preoperative worries and parental anxiety were evaluated after the experimental manipulation. Children who received educational materials were significantly less worried about surgery and hospital procedures than children in the comparison and the control groups, although no statistically differences were found between the type of materials within the experimental group, and no significant effect occurred on parental state anxiety. These results do however support the hypothesis that providing preoperative materials with educational information reduce children's preoperative worries.

  18. Salivary Concentration of Progesterone and Cortisol Significantly Differs Across Individuals After Correcting for Blood Hormone Values

    Science.gov (United States)

    Konishi, Shoko; Brindle, Eleanor; Guyton, Amanda; O’Connor, Kathleen A.

    2014-01-01

    Between-individual variation of salivary progesterone (P4) and cortisol levels does not always closely reflect blood hormone concentrations. This may be partly a function of individual differences in salivary hormone excretion. We tested whether time of day at sampling and ethnicity contributed to individual variation in salivary hormones after adjusting for blood hormone levels. Forty-three Caucasian and 15 Japanese women (18–34 years) collected four sets of matched dried blood spot (DBS) and saliva specimens across a menstrual cycle (N = 232 specimen sets). Linear fixed-effects (LFE) models were used to estimate the effects of diurnal variation and ethnicity on salivary P4 and cortisol while adjusting for DBS levels. For each hormone, women with exclusively positive or negative residuals (unexplained variance) from the LFE models were categorized as high- or low-saliva-to-DBS hormone ratio (SDR; high or low salivary secretors), respectively. We found that salivary P4 (P < 0.05) was significantly higher in early morning compared to the afternoon, after controlling for DBS levels, ethnicity, and BMI. After further adjusting for this diurnal effect, significant individual variation in salivary P4 and cortisol remained: sixteen and nine women, respectively were categorized as low or high salivary secretors for both hormones (P < 0.001), suggesting systematic individual-specific variation of salivary hormonal concentration. We conclude that when saliva is used to quantify P4 or cortisol levels, time of day at sampling should be controlled. Even with this adjustment, salivary P4 and cortisol do not closely mirror between-individual variation of serum P4 and cortisol in a substantial proportion of individuals. PMID:22826025

  19. Lippia alba morphotypes cidreira and melissa exhibit significant differences in leaf characteristics and essential oil profile

    Directory of Open Access Journals (Sweden)

    Caroline N. Jezler

    2013-04-01

    Full Text Available Lippia alba (Mill. N.E. Br. ex Britton & P. Wilson, Verbenaceae, is widely used in traditional Brazilian medicine for the treatment of abdominal distress. The species exhibits considerable chemical and morphological diversity, and various chemotypes have been characterized. A comparative study of L. alba, has been carried out of the morphoanatomical characteristics of the leaves and the profiles of the essential oils of the morphotypes cidreira and melissa grown in the Medicinal Plant Garden of the Universidade Estadual de Santa Cruz, Ilhéus, Bahia, Brazil. The mean plant height of cidreira was 1.80 m and the stems and branches were fairly erect, while melissa plants were smaller (1.60 m and presented prostrate stems and branches. Although the leaf of the morphotypes look were similar, the mean values of length, width and area of the leaves of cidreira (respectively, 7.42 cm, 3.32 cm and 17.31 cm² differed significantly from those of melissa (4.68 cm, 2.35 cm and 7.32 cm2. The morphotypes presented amphistomatic leaves with uniseriate epidermis on both surfaces. The mesophyll was dorsiventral, but in cidreira the palisade parenchyma was biseriate while in melissa it was uniseriate. Simple tector and capitate glandular trichomes were present on the adaxial and abaxial surfaces of the leaf blades of both morphotypes. Six distinct types of glandular trichomes could be distinguished: types I and II were present in both morphotypes, while type III was detected only in cidreira, and types IV to VI were present only in melissa. The two morphotypes also differed with respect to the composition of the essential oil, cidreira produced oil composed mainly of citral, while the oil from melissa was rich in citral, limonene and carvone.

  20. 风湿性左心瓣膜病变术中行三尖瓣矫治的临床价值%Clinical significance of tricuspid surgery in patients with rheumatic disease undergoing left-side valve surgery

    Institute of Scientific and Technical Information of China (English)

    陆小虎; 吴延虎; 张石江; 邵永丰; 秦建伟

    2012-01-01

    Objective To explore the clinical value of tricuspid dilatation as a criterion for rheumatic tricuspid regurgitatioa Methods A total o{ 104 patients with rheumatic disease underwent left-side valve surgery. Taking the tricuspid annular dimension ≥70 mm measured intraoperatively as the criterion. 30 patients with the tricuspid annular dimension <70 mm( group A) received left-side valve surgery only and 74 patients with the tricuspid annular dimension ≥70 mm( group B) received left side valve surgery plus tricuspid annuloplasty or tricuspid replacement. Results Cardiac function after surgery was inproved in both groups, which was more in group B than that in group A. Tricuspid regurgitation grade was significantly decreased postoperatively in group B, but which was worse in group A. Conclusion The tricuspid annular dimension 5≥ 70 mm may be taken as a criterion for tricuspid annuloplasty or tricuspid replacement.%目的 探讨以三尖瓣环扩大作为风湿性左心瓣膜病变术中三尖瓣关闭不全矫治指征的临床价值.方法 风湿性左心瓣膜疾病行手术治疗的患者104例分为单纯左心瓣膜置换30例(A组)和左心瓣膜置换加三尖瓣手术74例(B组)两组.B组术中测量三尖瓣环直径≥70 mm者行三尖瓣成形或置换手术.结果 两组术后心功能均较术前好转.B组术后心功能明显好于A组.B组术后三尖瓣返流程度明显改善,而A组三尖瓣返流程度较术前加重.结论 三尖瓣环直径≥70 mm可以作为风湿性左心瓣膜病变术中三尖瓣成形或置换手术的一个指征.

  1. Prolapse assessment supine and standing: do we need different cutoffs for "significant prolapse"?

    Science.gov (United States)

    Rodríguez-Mias, Nuria-Laia; Subramaniam, Nishamini; Friedman, Talia; Shek, Ka Lai; Dietz, Hans Peter

    2017-04-25

    Translabial ultrasound (TLUS) has shown good correlations between clinical examination and imaging findings in the supine position, and limits of normality have been described. This is not the case for imaging in the standing position. This study was designed to test the hypothesis that different cutoff values are required for imaging in the standing position. This was a retrospective study carried out in a tertiary urogynecological unit in women presenting with symptoms of lower urinary tract and pelvic floor dysfunction between August 2013 and December 2015. All women underwent a standardized interview, 4D TLUS and a POP-Q assessment. Organ descent on ultrasound was measured relative to the postero-inferior margin of the symphysis pubis (SP) on maximal Valsalva in the supine and standing positions. Receiver operator characteristic (ROC) statistics were used to determine optimal cutoffs for "normal" pelvic organ support. We assessed 243 data sets. Mean patient age was 57 years. Prolapse symptoms were reported by 59.2%, and POP of stage ≥ 2 was found in 82.3%. On analysing imaging data sets obtained in the standing position, we obtained similar cutoff values to those established previously for supine imaging, using ROC statistics. The levator hiatus distended significantly more on Valsalva in the standing position compared with supine, and on ROC analysis we identified a new optimal cutoff of 29 cm(2). Established cutoffs for supine imaging of organ descent are suitable for imaging in the standing position. Hiatal distensibility may require a higher cutoff of 29 cm(2).

  2. Isolation and characterization of different strains of Bacillus licheniformis for the production of commercially significant enzymes.

    Science.gov (United States)

    Ghani, Maria; Ansari, Asma; Aman, Afsheen; Zohra, Rashida Rahmat; Siddiqui, Nadir Naveed; Qader, Shah Ali Ul

    2013-07-01

    Utilization of highly specific enzymes for various industrial processes and applications has gained huge momentum in the field of white biotechnology. Selection of a strain by efficient plate-screening method for a specific purpose has also favored and boosted the isolation of several industrially feasible microorganisms and screening of a large number of microorganisms is an important step in selecting a potent culture for multipurpose usage. Five new bacterial isolates of Bacillus licheniformis were discovered from indigenous sources and characterized on the basis of phylogeny using 16S rDNA gene analysis. Studies on morphological and physiological characteristics showed that these isolates can easily be cultivated at different temperatures ranging from 30°C to 55°C with a wide pH values from 3.0 to 11.0 All these 05 isolates are salt tolerant and can grow even in the presences of high salt concentration ranging from 7.0 to 12.0%. All these predominant isolates of B. licheniformis strains showed significant capability of producing some of the major industrially important extracellular hydrolytic enzymes including α-amylase, glucoamylase, protease, pectinase and cellulase in varying titers. All these isolates hold great potential as commercial strains when provided with optimum fermentation conditions.

  3. Different activation patterns in the plasma kallikrein-kinin and complement systems during coronary bypass surgery.

    Science.gov (United States)

    Kongsgaard, U E; Smith-Erichsen, N; Geiran, O; Amundsen, E; Mollnes, T E; Garred, P

    1989-07-01

    Components of the plasma kallikrein-kinin and complement systems were determined in patients undergoing open heart surgery with cardiopulmonary bypass. Spontaneous kallikrein activity (KK), plasma prekallikrein (PKK), functional kallikrein inhibition capacity (KKI), C3 activation products (C3-act), and the terminal complement complex (TCC) were measured. A marked, transitory increase in KK and a decrease in PKK were found prior to cardiopulmonary bypass just after heparin injection. An additional decline in PKK and KKI during bypass with a return to near control levels in the postoperative period was observed. C3-act increased in all patients during bypass, reaching a peak value at wound closure. The TCC concentration also increased significantly during cardiopulmonary bypass, returned to control levels in the early postoperative period, and then increased again in the late postoperative period. It is concluded that activation of the kallikrein-kinin system started after injection of heparin, prior to cardiopulmonary bypass. Activation of both the initial and the terminal complement cascade, however, started only after onset of cardiopulmonary bypass.

  4. Basal Cell Carcinoma Surgery: Simple Undermining Approach in Two Patients with Different Tumour Locations

    Directory of Open Access Journals (Sweden)

    Georgi Tchernev

    2017-07-01

    Full Text Available Basal cell carcinoma (BCC is the most common human malignancy, accounting for the majority of all non-melanoma skin cancers (NMSC. In the past several decades the worldwide incidence of BCC has constantly been increasing. Even though it is a slow growing tumour that, left untreated, rarely metastasizes, it has a distinctive invasive growth pattern, posing a considerable risk for local invasion and destruction of underlying tissues, such as muscle, cartilage, bone or vital structures. Advanced BCCs include such locally invasive or metastatic tumours. Complete surgical excision is the standard therapy for most uncomplicated BCC cases with good prognosis and cure rates. Treatment of advanced forms of BCCs poses significant therapeutic challenges, most often requiring complicated surgery, radiotherapy, and/or targeted therapies directed towards the sonic hedgehog signalling pathway (SHH. We present two cases of large BCCs located on the scalp and posterior thorax, which underwent surgical excision with clear margins, followed by reconstruction of the defect after extensive undermining of the skin.

  5. Outcomes of patients with syringomyelia undergoing spine deformity surgery: do large syrinxes behave differently from small?

    Science.gov (United States)

    Samdani, Amer F; Hwang, Steven W; Singla, Anuj; Bennett, James T; Ames, Robert J; Kimball, Jeff S

    2017-04-13

    A paucity of data exist studying outcomes of patients with syringomyelia undergoing spinal deformity correction. The literature does not stratify patients by syrinx size, which is likely a major contributor to outcomes. The study aimed to compare differences in outcomes between patients with large (≥4 mm) and small syrinxes (4 mm] and 17 with small syrinx [SS, <4 mm]). The outcome measures were radiographic, operative, and neurophysiological measures. We retrospectively reviewed 28 patients with syringomyelia who underwent spine deformity surgery with 2-year follow-up. Demographic, surgical, and radiographic data were collected and compared preoperatively and at 2 years. The LS group (11 patients) trended toward more left-sided thoracic curves (36% vs. 18%, p=.38) and was more likely to have had a Chiari decompression (45% vs. 12%, p=.08). The LS patients had larger preoperative major curves (LS=66° vs. SS=57°, p=.05), more thoracic kyphosis (LS=42°, SS=24°, p<.01), and greater rib prominences (LS=16°, SS=13°, p=.04). The LS patients had more levels fused (LS=12.2, SS=11.2, p=.05), higher estimated blood loss (EBL) (LS=1068 cc, SS=832 cc, p=.04), and a trend toward less percent correction of the major curve (LS=57%, SS=65%, p=.18). Four of 11 LS patients (36%) did not have somatosensory evoked potentials, and one of these also did not have motor evoked potentials. Neuromonitoring changes occurred in 3 of 11 (27%) LS patients and in none of the SS patients, with no postoperative deficits. Outcomes of patients with syringomyelia undergoing spine deformity surgery are dependent on the size of the syrinx. Those with large syringomyelia are fused longer with more EBL and less correction. Spine surgeons should be aware that these patients are more likely to have less reliable neuromonitoring, with a higher chance of experiencing a change. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Comparison of surgical conditions in 2 different anesthesia techniques of esmolol-induced controlled hypotension in breast reduction surgery

    Science.gov (United States)

    Besir, Ahmet; Cekic, Bahanur; Kutanis, Dilek; Akdogan, Ali; Livaoglu, Murat

    2017-01-01

    Abstract Background: Breast reduction surgery is a common cosmetic surgery with a high incidence of blood loss and transfusion. In this surgery, the reduction of blood loss related to surgical manipulation and the volume of resected tissue is a target. In the present study, we compared the effects of esmolol-induced controlled hypotension on surgical visibility, surgical bleeding, and the duration of surgery in patients anesthetized with propofol/remifentanil (PR) or sevoflurane/remifentanil (SR). Methods: Patients in the American Society of Anesthesiologists I/II risk group undergoing breast reduction surgery were prospectively randomized into PR (n = 25) and SR (n = 25) groups. Controlled hypotension was induced with esmolol in both groups. During the intraoperative period, the heart rate (HR), mean arterial pressure (MAP), operation duration, volume of intraoperative blood loss, volume of blood received through postoperative drains, volume of resected tissues, and surgical area bleeding score were recorded. Results: The duration of operation in the incisional period was shorter in group PR compared to group SR (P = 0.04). The change in HR was lower in incision and hemostasis periods in the group PR compared to the group SR (P blood received through drains on postoperative postoperative day 1, day 2, and in total were found to be significantly lower in group PR compared to group SR. Surgical visibility scoring was more effective in group PR compared to SR. Conclusion: In the breast reduction surgery performed under esmolol-induced controlled hypotension, the effect of propofol + remifentanil anesthesia on the duration of incisional surgery, surgical visibility, and volume of surgical blood loss was more reliable and effective compared to that of sevoflurane + remifentanil, which seems to be an advantage. PMID:28272228

  7. Significance of nitrogen removal mass in uremic patients on different modalities of dialysis therapy.

    Science.gov (United States)

    Chen, T W; Huang, T P; Wang, M L

    2000-02-01

    While most nephrologists use Kt/V values for dialysis prescriptions, some researchers are beginning to view the role of solute removal mass as an indicator of adequate dialysis. This study, using nitrogen as a surrogate for solute removal, probed whether solute removal mass can be used as the target of adequate dialysis. Mathematical formulas for easy bedside calculation of nitrogen removal mass were used to avoid the problems associated with direct measurement. The weekly removal mass of urea nitrogen (M) and the urea generation rate (G) of 32 conventional hemodialysis (HD) and 21 continuous ambulatory peritoneal dialysis (CAPD) patients were calculated. All the patients were anuric, clinically stable, and under adequate dialysis pursuant to either the criterion of the urea index, Kt/V, or clinical requirements. The difference in MHD (MHD = 41.9 +/- 9.5 g/week, MCAPD = 38.8 +/- 11.9 g/week) and G (GHD = 3.90 +/- 1.02 mg/min, GCAPD = 3.85 +/- 1.21 mg/min) between the two groups was statistically insignificant (p = 0.119 and p = 0.868, respectively). When protein nitrogen leaking through the peritoneal membrane was considered and added to MCAPD, nitrogen removal in CAPD patients (M'CAPD = 42.3 +/- 13.0 g/week) approached that in HD patients (p = 0.886). There was no correlation between dialysis dosage and urea removal mass in either the CAPD or HD groups. Urea nitrogen removal mass is similar to the protein catabolic rate (PCR) in stable patients. It is meaningful in dialysis evaluation only when it is used simultaneously with blood urea nitrogen measurement. However, because M changes at the inception of dialysis, it more significant than PCR in the evaluation of unstable patients.

  8. Difference in clinical outcome between total shoulder arthroplasty and reverse shoulder arthroplasty used in hemiarthroplasty revision surgery

    NARCIS (Netherlands)

    Hartel, B.P.; Alta, T.D.; Sewnath, M.E.; Willems, W.J.H.

    2015-01-01

    INTRODUCTION: The increase of shoulder replacements will lead to a higher revision rate of shoulder arthroplasties. The aim of this study is to evaluate the clinical results of revision surgery performed in our hospital, distinguish the differences in clinical outcome according to revision indicatio

  9. Can we improve the efficacy of modern cataract surgery by using different tip designs? A comparison of balanced and tapered tip in femtosecond laser-assisted cataract surgery and manual phacoemulsification.

    Science.gov (United States)

    Pahlitzsch, Milena; Pahlitzsch, Marie-Luise; Sumarni, Uly; Pahlitzsch, Thomas

    2017-05-31

    Different tip designs in modern cataract surgery have not been studied between the reported systems. Aim of this study is to assess the efficacy of two tip designs, Intrepid® balanced tip (BT) and Kelman tapered tip (TT), in femtosecond laser assisted cataract surgery (FLACS) and the microcoaxial torsional phacoemulsification. Prospective randomized unmasked cohort outcome study (hospital setting). Threehundert-forty-three eyes of 343 patientes underwent cataract surgery. Data of n = 196 FLACS and n = 147 manual phacoemulsification were analysed. Intrepid® balanced tip and Kelman tapered tip, Alcon, USA, were tested in FLACS (LenSx Alcon, USA) und manual phaco (Alcon Centurion System, USA). Four study cohorts were formed; FLACS BT (n = 90, 70.2 years), FLACS TT (n = 106, 68.1years), Manual BT (n = 70, 71.3 years), Manual TT (n = 77, 71.8 years). The nuclei were graded in Lens Opacities Classification System (LOCS) II,III and IV. Cumulative dissipated energy (CDE%s), balanced salt solution volume (BSSml), total longitudinal energy (%s) and torsional amplitude (%s). Lower CDE values were seen in FLACS compared to manual phacoemulsification (CDE %s median FLACS BT 3.28, FLACS TT 4.07, Manual BT 5.57, Manual TT 6.27). There was a significant difference between CDE FLACS BT and FLACS TT (p = 0.038), and between FLACS BT and Manual TT (p = 0.001). The right choice of tip designs in advanced phacoemulsification systems is a key factor in increasing efficacy in cataract surgery. The balanced tip showed a considerable energy-saving advantage in FLACS and manual phacoemulsification compared to the tapered tip. © 2017 Royal Australian and New Zealand College of Ophthalmologists.

  10. Intraoperative frozen section analysis of margins in breast conserving surgery significantly decreases reoperative rates: one-year experience at an ambulatory surgical center.

    Science.gov (United States)

    Jorns, Julie M; Visscher, Daniel; Sabel, Michael; Breslin, Tara; Healy, Patrick; Daignaut, Stephanie; Myers, Jeffrey L; Wu, Angela J

    2012-11-01

    Intraoperative frozen section (FS) margin evaluation is not common practice for patients undergoing breast conservation therapy (BCT), but offers a significant reduction in reoperation. In this study, a technique to allow for more effective freezing of breast tissue was developed to perform FS evaluation of lumpectomy margins (FSM) for all patients undergoing BCT at an ambulatory surgery center. FS evaluation of sentinel lymph node biopsy specimens was performed concurrently. One hundred eighty-one study and 188 control patients, with and without FS evaluation, were compared. Reexcision was reduced 34% (from 48.9% to 14.9%) and reoperation was reduced 36% (from 55.3% to 19.3%) with FS evaluation. Most of the decrease in reoperative rate was because of a decrease in the need for margin reexcision. The number of patients requiring 1, 2, or 3 operations to complete therapy was 84, 92, and 12, respectively, in the control group, and 146, 33, and 2, respectively, in the study group. Lobular subtype, multifocal disease, and larger tumor size (≥2 cm) were significantly associated with failure of FSM to prevent reoperation, but reoperation rates were still significantly decreased in this subgroup of patients (from 75.5% to 43.8%) with FSM. This study highlights an innovative yet simple and adaptable FS approach that resulted in a nearly 3-fold reduction in reoperation for patients undergoing BCT.

  11. Local Anesthesia in Cataract Surgery-A Comparison of Different Methods

    Institute of Scientific and Technical Information of China (English)

    Nolan; J; Aziz; M; Ahmad; M; Shehata; M; Iqbal; F

    1993-01-01

    Seven groups of thirty patients undergoing cataract extraction under local anesthesia were each given different combinations of local anesthesia. These varied from a maximum approach using supra-orbital, infra-orbital and facial blocks with Hyalase, orbital compression and pre-operative Acetazolamide down to a minimum group receiving purely an infra- orbital and supra-orbital block with a Ugnocaine/Bupivacaine mixture. There was no significant difference in local analgesia or in the complication rates b...

  12. Eye-hand preference in schizophrenia: sex differences and significance for hand function.

    Science.gov (United States)

    Liu, Yi-Chia; Yang, Yen Kuang; Lee, I Hui; Lin, Keh-Chung; Jeffries, Keith J; Lee, Li-Ching

    2004-06-01

    Hand preference and eye dominance were investigated in 73 (30 women, 43 men) schizophrenic patients and 71 (30 women, 41 men) healthy controls. There were significantly more schizophrenic patients and normal controls who were significantly right-hand dominant. However, schizophrenic patients showed a significant excess of left-eye dominance relative to controls (65.8% vs 29.6%; Odds Ratio= 4.75, peye dominance (80%) than male schizophrenic patients (55.8%) and controls (33.3%). Analysis of hand performance on the Purdue Pegboard Test indicated that schizophrenic patients who showed crossed eye-hand dominance scored higher than did patients without crossed eye-hand dominance.

  13. Faculty Decisions on Serials Subscriptions Differ Significantly from Decisions Predicted by a Bibliometric Tool.

    Directory of Open Access Journals (Sweden)

    Sue F. Phelps

    2016-03-01

    of the faculty choices. The p-value for this relationship was less than 0.0001, also indicating that the result was not by chance. A quadratic model plotted alongside the previous linear model follows a similar pattern. The p-value of the comparison is 0.0002, which indicates the quadratic model’s fit cannot be explained by random chance. Main Results – The authors point out three outstanding findings. First, the match rate between faculty valuations and bibliometric scores for serials is 65%. This exceeds the 50% rate that would indicate random association, but also indicates a statistically significant difference between faculty and bibliometric valuations. Secondly, the match rate with the bibliometric scores for titles that faculty chose to keep (73% was higher than those they chose to cancel (54%. Thirdly, the match rate increased with higher bibliometric scores. Conclusions – Though the authors identify only a modest degree of similarity between faculty and bibliometric valuations of serials, it is noted that there is more agreement in the higher valued serials than the lower valued serials. With that in mind, librarians might focus faculty review on the lower scoring titles in the future, taking into consideration that unique faculty interests may drive selection at that level and would need to be balanced with the mission of the library.

  14. Significant regional differences in Denmark in outcome after cochlear implants in children

    DEFF Research Database (Denmark)

    Percy-Smith, Lone; Busch, Georg Walter; Sandahl, Minna;

    2012-01-01

    The objectives of the present study were to study regional differences in outcome for a paediatric cochlear implant (CI) population after the introduction of universal neonatal hearing screening (UNHS) and bilateral implantation in Denmark.......The objectives of the present study were to study regional differences in outcome for a paediatric cochlear implant (CI) population after the introduction of universal neonatal hearing screening (UNHS) and bilateral implantation in Denmark....

  15. [Sex differences in body image of adolescents and significance for self esteem].

    Science.gov (United States)

    Roth, Marcus

    2002-03-01

    Previous findings show that the body image of adolescents is in the first place gender related. However, most studies primarily focus on body cathexis. The present study, which was conducted in the context of a multi-dimensional perspective, refers to the question of gender differences in the adolescent's body image. Furthermore, it examines what relevance the single components of the body image have for general self-esteem. Therefore, we tested 326 adolescents aged 13 to 16 using questionnaires. The results indicate that there is primarily evidence for gender differences, whereas age related differences can hardly be found: Female adolescents differ from their male counterparts for example in the following aspects: they have a higher body awareness, a higher dissatisfaction with their shape, a lower perceived athletic competence and stronger feelings of depersonalisation. However, considering the effect sizes, it becomes clear that the differences mainly come up to only a low extend. Besides, the individual body image profile is hardly suitable to determine the gender of the adolescents. Furthermore, using regression analysis it was shown that altogether the body image has the same relevance for males and females in order to predict self-esteem. Nevertheless, there are special body image components that help to predict body image for boys and girls differently. The results show that the body image of adolescents is gender-depending but not gender specific. So demand arises for investigating the determinants of the development of the adolescent's body image that go beyond the gender-variable.

  16. Do the different types of renal surgery impact the quality of life in the postoperative period?

    DEFF Research Database (Denmark)

    Azawi, Nessn H.; Tesfalem, H; Dahl, C

    2015-01-01

    PURPOSE: Because more than 70 % of patients with localized tumors experience 10 years of cancer-specific survival, their quality of life (QoL) after surgery is important. The aim of this study was to explore the impact of the type of surgery (partial vs. total nephrectomy) and the postoperative...... outcome on the QoL of patients with renal cancer. METHODS: A total of 205 patients underwent partial or total nephrectomy at the Department of Urology, Roskilde Hospital, between February 2008 and June 2013 and survived until the time of the survey. The European Organization for Research and Treatment...

  17. A different management of saphenous vein graft failure related to cardiac tamponade following coronary surgery

    Directory of Open Access Journals (Sweden)

    Hamit Serdar Başbuğ

    2016-03-01

    Full Text Available Cardiac tamponade is a state of constriction of the heart with an excessive fluid or hematoma resulted from various conditions. Postoperative tamponade can occur after coronary bypass surgery. Despite it is uncommon, its results may have a high risk of mortality and morbidity. Acute postoperative cardiac tamponade reveals a vast spectrum of symptoms. Moreover, a compression over the saphenous vein graft is the worst complication that should be managed without delay. We report a rare case of saphenous vein graft failure due to the cardiac tamponade following a coronary surgery and its management with a practical measure.

  18. Null hypothesis significance tests. A mix-up of two different theories

    DEFF Research Database (Denmark)

    Schneider, Jesper Wiborg

    2015-01-01

    Null hypothesis statistical significance tests (NHST) are widely used in quantitative research in the empirical sciences including scientometrics. Nevertheless, since their introduction nearly a century ago significance tests have been controversial. Many researchers are not aware of the numerous......-Bayesian interpretations. This is undoubtedly a major reason why NHST is very often misunderstood. But NHST also has intrinsic logical problems and the epistemic range of the information provided by such tests is much more limited than most researchers recognize. In this article we introduce to the scientometric community...

  19. Clinical Significance of Magnetic Resonance Imaging before Complex Anal Fistula Surgery%术前磁共振检查在复杂性肛瘘手术中的临床意义

    Institute of Scientific and Technical Information of China (English)

    孙平良; 陈文福; 李晶; 黄艳; 蒙建兴

    2011-01-01

    rate, healing time and the recurrence rate in half a year. Results In comparison between low - lever fistula observation group and low - level fistula control group, it was found during the surgery that there were no statistical significant differences in the number of internal opening, surgical frequency, re - surgical rate, healing time and the recurrence rate( P > 0.05 ). In comparison between high - level fistula observation group and high- level fistula control group, it was discovered during the surgery that the significant statistical differences presented in the number of internal opening, surgical frequency and healing time( P < 0.05 ). The resurgical rate in high -level fistula control group was higher than that in high -level observation group, but without statistical different significance( P > 0.05 ). The precision for the location of internal opening in MRI in high - level fistula observation group was higher than that in low - level fistula operation, but without statistical different significance( P > 0.05 ). Conclusion MRI before the surgery can improve the clinical efficacy on high -level complex anal fistula and this examination should become the routine examination item before the surgery for high - level complex anal fistula.

  20. Do Age and Sex of School Students Make Significant Difference in Their Multiple Intelligences?

    Science.gov (United States)

    Ravi, R.; Vedapriya, S. Gethsi

    2009-01-01

    Multiple Intelligences are a new educational theory proposed by Howard Gardner in 1983. Multiple intelligences describe an array of different kinds of intelligences exhibited by human beings. This theory consists of verbal-linguistic, logical and mathematics, visual and spatial, bodily kinesthetic, musical-rhythmic, intrapersonal, interpersonal,…

  1. Conventions of Courtship: Gender and Race Differences in the Significance of Dating Rituals

    Science.gov (United States)

    Jackson, Pamela Braboy; Kleiner, Sibyl; Geist, Claudia; Cebulko, Kara

    2011-01-01

    Dating rituals include dating--courtship methods that are regularly enacted. This study explores gender and race differences in the relative importance placed on certain symbolic activities previously identified by the dating literature as constituting such rituals. Using information collected from a racially diverse sample of college students (N…

  2. Age Differences in Coping, Behavioral Dysfunction and Depression Following Colostomy Surgery.

    Science.gov (United States)

    Keyes, Kathryn; And Others

    1987-01-01

    Examined the responses of a group of middle-aged and older adults (N=34) to colostomy surgery. Analyzed the relationship between the method and focus of coping and age, sickness-related dysfunction, and depression. Found that neither a lower level of active behavioral coping nor age itself was correlated with depression or dysfunction. (Author/ABB)

  3. A systematic review of the effect of different crimping techniques in stapes surgery for otosclerosis.

    NARCIS (Netherlands)

    Wegner, Inge; Swartz, Justin E; Bance, Manohar L; Grolman, Wilko

    OBJECTIVES/HYPOTHESIS To evaluate the effect of crimping techniques in stapes surgery for otosclerosis patients measured by hearing outcomes on pure-tone audiometry. DATA SOURCES PubMed, EMBASE, and the Cochrane Library. METHODS A systematic search was conducted. Studies comparing the effect of

  4. Different duration strategies of perioperative antibiotic prophylaxis in adult patients undergoing cardiac surgery : an observational study

    NARCIS (Netherlands)

    Hamouda, Khaled; Oezkur, Mehmet; Sinha, Bhanu; Hain, Johannes; Menkel, Hannah; Leistner, Marcus; Leyh, Rainer; Schimmer, Christoph

    2015-01-01

    Background: All international guidelines recommend perioperative antibiotic prophylaxis (PAB) should be routinely administered to patients undergoing cardiac surgery. However, the duration of PAB is heterogeneous and controversial. Methods: Between 01.01.2011 and 31.12.2011, 1096 consecutive cardiac

  5. Significance of different animal species in experimental models for in vivo investigations of hematopoiesis

    Directory of Open Access Journals (Sweden)

    Kovačević-Filipović Milica

    2004-01-01

    Full Text Available Numerous discoveries in medicine are results of experiments on different animal species. The most frequently used animals in hematopoiesis investigations are laboratory mice and rats, but so-called big animals, such as pigs, sheep, cats, dogs, and monkeys, evolution-wise closer to humans have a place in experimental hematology as well. The specific problematics of a certain animal specie can lead to fundamental knowledge on certain aspects of the process of hematopoiesis end the biology of stem cells in hematopoiesis. Furthermore, comparative investigations of certain phenomena in different species help in the recognition of the general rules in the living world. In the area f preclinicalinvesti- gations, animal models are an inevitable step in studies of transplantation biology of stem cells in hematopoiesis, as well as in studies of biologically active molecules which have an effect on the hematopoietic system. Knowledge acquired on animal models is applied in both human and veterinary medicine.

  6. The Formation of the Polyploid Hybrids From Different Subfamily Fish Crossings and Its Evolutionary Significance

    OpenAIRE

    Liu, Shaojun; Qin, Qinbo; Xiao, Jun; Lu, Wenting; Shen, Jiamin; Li, Wei; Liu, Jifang; Duan, Wei; Zhang, Chun; Tao, De Min; Zhao, Rurong; Yan, Jinpeng; Liu, Yun

    2007-01-01

    This study provides genetic evidences at the chromosome, DNA content, DNA fragment and sequence, and morphological levels to support the successful establishment of the polyploid hybrids of red crucian carp × blunt snout bream, which belonged to a different subfamily of fish (Cyprininae subfamily and Cultrinae subfamily) in the catalog. We successfully obtained the sterile triploid hybrids and bisexual fertile tetraploid hybrids of red crucian carp (RCC) (♀) × blunt snout bream (BSB) (♂) as w...

  7. The significance of different diacylgycerol synthesis pathways on plant oil composition and bioengineering

    Directory of Open Access Journals (Sweden)

    Philip David Bates

    2012-07-01

    Full Text Available The unique properties of vegetable oils from different plants utilized for food, industrial feedstocks, and fuel is dependent on the fatty acid (FA composition of triacylglycerol (TAG. Plants can use two main pathways to produce diacylglycerol (DAG, the immediate precursor molecule to TAG synthesis: 1 De novo DAG synthesis, and 2 conversion of the membrane lipid phosphatidylcholine (PC to DAG. The FA esterified to PC are also the substrate for FA modification (e.g. desaturation, hydroxylation, etc., such that the FA composition of PC-derived DAG can be substantially different than that of de novo DAG. Since DAG provides two of the three FA in TAG, the relative flux of TAG synthesis from de novo DAG or PC-derived DAG can greatly affect the final oil FA composition. Here we review how the fluxes through these two alternate pathways of DAG/TAG synthesis are determined and present evidence that suggests which pathway is utilized in different plants. Additionally, we present examples of how the endogenous DAG synthesis pathway in a transgenic host plant can produce bottlenecks for engineering of plant oil FA composition, and discuss alternative strategies to overcome these bottlenecks to produce crop plants with designer vegetable oil compositions.

  8. Postexercise Glycogen Recovery and Exercise Performance is Not Significantly Different Between Fast Food and Sport Supplements.

    Science.gov (United States)

    Cramer, Michael J; Dumke, Charles L; Hailes, Walter S; Cuddy, John S; Ruby, Brent C

    2015-10-01

    A variety of dietary choices are marketed to enhance glycogen recovery after physical activity. Past research informs recommendations regarding the timing, dose, and nutrient compositions to facilitate glycogen recovery. This study examined the effects of isoenergetic sport supplements (SS) vs. fast food (FF) on glycogen recovery and exercise performance. Eleven males completed two experimental trials in a randomized, counterbalanced order. Each trial included a 90-min glycogen depletion ride followed by a 4-hr recovery period. Absolute amounts of macronutrients (1.54 ± 0.27 g·kg-1 carbohydrate, 0.24 ± 0.04 g·kg fat-1, and 0.18 ±0.03g·kg protein-1) as either SS or FF were provided at 0 and 2 hr. Muscle biopsies were collected from the vastus lateralis at 0 and 4 hr post exercise. Blood samples were analyzed at 0, 30, 60, 120, 150, 180, and 240 min post exercise for insulin and glucose, with blood lipids analyzed at 0 and 240 min. A 20k time-trial (TT) was completed following the final muscle biopsy. There were no differences in the blood glucose and insulin responses. Similarly, rates of glycogen recovery were not different across the diets (6.9 ± 1.7 and 7.9 ± 2.4 mmol·kg wet weight- 1·hr-1 for SS and FF, respectively). There was also no difference across the diets for TT performance (34.1 ± 1.8 and 34.3 ± 1.7 min for SS and FF, respectively. These data indicate that short-term food options to initiate glycogen resynthesis can include dietary options not typically marketed as sports nutrition products such as fast food menu items.

  9. The formation of the polyploid hybrids from different subfamily fish crossings and its evolutionary significance.

    Science.gov (United States)

    Liu, Shaojun; Qin, Qinbo; Xiao, Jun; Lu, Wenting; Shen, Jiamin; Li, Wei; Liu, Jifang; Duan, Wei; Zhang, Chun; Tao, Min; Zhao, Rurong; Yan, Jinpeng; Liu, Yun

    2007-06-01

    This study provides genetic evidences at the chromosome, DNA content, DNA fragment and sequence, and morphological levels to support the successful establishment of the polyploid hybrids of red crucian carp x blunt snout bream, which belonged to a different subfamily of fish (Cyprininae subfamily and Cultrinae subfamily) in the catalog. We successfully obtained the sterile triploid hybrids and bisexual fertile tetraploid hybrids of red crucian carp (RCC) (female symbol) x blunt snout bream (BSB) (male symbol) as well as their pentaploid hybrids. The triploid hybrids possessed 124 chromosomes with two sets from RCC and one set from BSB; the tetraploid hybrids had 148 chromosomes with two sets from RCC and two sets from BSB. The females of tetraploid hybrids produced unreduced tetraploid eggs that were fertilized with the haploid sperm of BSB to generate pentaploid hybrids with 172 chromosomes with three sets from BSB and two sets from RCC. The ploidy levels of triploid, tetraploid, and pentaploid hybrids were confirmed by counting chromosomal number, forming chromosomal karyotype, and measuring DNA content and erythrocyte nuclear volume. The similar and different DNA fragments were PCR amplified and sequenced in triploid, tetraploid hybrids, and their parents, indicating their molecular genetic relationship and genetic markers. In addition, this study also presents results about the phenotypes and feeding habits of polyploid hybrids and discusses the formation mechanism of the polyploid hybrids. It is the first report on the formation of the triploid, tetraploid, and pentaploid hybrids by crossing parents with a different chromosome number in vertebrates. The formation of the polyploid hybrids is potentially interesting in both evolution and fish genetic breeding.

  10. Significant gender difference in serum levels of fibroblast growth factor 21 in Danish children and adolescents

    DEFF Research Database (Denmark)

    Bisgaard, Amalie; Sørensen, Kaspar; Johannsen, Trine Holm

    2014-01-01

    INTRODUCTION: Fibroblast Growth Factor 21 (FGF21) is a novel metabolic factor with effect on glucose and lipid metabolism, and shown to be elevated in diseases related to metabolic syndrome. Due to the increasing frequency of metabolic syndrome in the pediatric population, and as FGF21 studies...... in children are limited, we investigated baseline serum levels of FGF21 in healthy children during an oral glucose tolerance test. METHODS: A total of 179 children and adolescents from the COPENHAGEN Puberty Study were included. An OGTT with glucose and insulin measurements, a dual energy X-ray absorptiometry...... (DXA) scan and a clinical examination including pubertal staging were done on all subjects. Serum levels of FGF21, adiponectin, and leptin were determined by immunoassays at baseline. RESULTS: The girls had significantly higher levels of FGF21 compared with boys (155 pg/mL vs. 105 pg/mL, P = 0.04). 38...

  11. Personality and individual differences in the horse, their significance, use and measurement.

    Science.gov (United States)

    Mills, D S

    1998-11-01

    The biological diversity of a species gives rise to individual differences in behavioural tendency. Traditionally, this variation has been considered to be of little scientific importance or value, but the description and quantification of the fundamental basis of this variability is relevant to many aspects of equine science. The reliable identification of these features may allow the development of more accurate diagnostic and prognostic indicators for a range of clinical diseases. Biologically based traits also provide a more rational basis for selective management and breeding programmes in which specific behavioural tendencies are sought. Individual differences in behaviour also reflect the range of subjective feelings experienced by animals and therefore need to be understood by those concerned with animal welfare. Psychometric techniques concerned with the assessment of personality may provide a suitable basis for scientific study in this field. Potentially methodologies include: behavioural tests, objective behaviour measures or the quantification of reports from those familiar with the subjects. The assessment of the validity and reliability of the variables measured in these tests is an integral part of their development. Interobserver correlation in an experiment based on the subjective rating of 20 horses with respect to 14 familiar terms used to describe horse personality was generally low. This suggests that, with the exception of the terms 'flighty' and 'sharp', the empirical terminology commonly used to describe horse personality is unreliable.

  12. Harvesting yeast (Saccharomyces cerevisiae) at different physiological phases significantly affects its functionality in bread dough fermentation.

    Science.gov (United States)

    Rezaei, Mohammad N; Dornez, Emmie; Jacobs, Pieter; Parsi, Anali; Verstrepen, Kevin J; Courtin, Christophe M

    2014-05-01

    Fermentation of sugars into CO2, ethanol and secondary metabolites by baker's yeast (Saccharomyces cerevisiae) during bread making leads to leavening of dough and changes in dough rheology. The aim of this study was to increase our understanding of the impact of yeast on dough related aspects by investigating the effect of harvesting yeast at seven different points of the growth profile on its fermentation performance, metabolite production, and the effect on critical dough fermentation parameters, such as gas retention potential. The yeast cells harvested during the diauxic shift and post-diauxic growth phase showed a higher fermentation rate and, consequently, higher maximum dough height than yeast cells harvested in the exponential or stationary growth phase. The results further demonstrate that the onset of CO2 loss from fermenting dough is correlated with the fermentation rate of yeast, but not with the amount of CO2 that accumulated up to the onset point. Analysis of the yeast metabolites produced in dough yielded a possible explanation for this observation, as they are produced in different levels depending on physiological phase and in concentrations that can influence dough matrix properties. Together, our results demonstrate a strong effect of yeast physiology at the time of harvest on subsequent dough fermentation performance, and hint at an important role of yeast metabolites on the subsequent gas holding capacity.

  13. Low cardiac output syndrome in the postoperative period of cardiac surgery. Profile, differences in clinical course and prognosis. The ESBAGA study.

    Science.gov (United States)

    Pérez Vela, J L; Jiménez Rivera, J J; Alcalá Llorente, M Á; González de Marcos, B; Torrado, H; García Laborda, C; Fernández Zamora, M D; González Fernández, F J; Martín Benítez, J C

    2017-07-20

    An analysis is made of the clinical profile, evolution and differences in morbidity and mortality of low cardiac output syndrome (LCOS) in the postoperative period of cardiac surgery, according to the 3 diagnostic subgroups defined by the SEMICYUC Consensus 2012. A multicenter, prospective cohort study was carried out. ICUs of Spanish hospitals with cardiac surgery. A consecutive sample of 2,070 cardiac surgery patients was included, with the analysis of 137 patients with LCOS. No intervention was carried out. The mean patient age was 68.3±9.3 years (65.2% males), with a EuroSCORE II of 9.99±13. NYHA functional class III-IV (52.9%), left ventricular ejection fraction<35% (33.6%), AMI (31.9%), severe PHT (21.7%), critical preoperative condition (18.8%), prior cardiac surgery (18.1%), PTCA/stent placement (16.7%). According to subgroups, 46 patients fulfilled hemodynamic criteria of LCOS (group A), 50 clinical criteria (group B), and the rest (n=41) presented cardiogenic shock (group C). Significant differences were observed over the evolutive course between the subgroups in terms of time subjected to mechanical ventilation (114.4, 135.4 and 180.3min in groups A, B and C, respectively; P<.001), renal replacement requirements (11.4, 14.6 and 36.6%; P=.007), multiorgan failure (16.7, 13 and 47.5%), and mortality (13.6, 12.5 and 35.9%; P=.01). The mean maximum lactate concentration was higher in cardiogenic shock patients (P=.002). The clinical evolution of these patients leads to high morbidity and mortality. We found differences between the subgroups in terms of the postoperative clinical course and mortality. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  14. Valor de la grasaepicárdica en el diagnóstico de aterosclerosiscoronariaprevio a cirugíavalvular/ Significance of epicardial fat in the diagnosis of coronary atherosclerosis before heart valve surgery

    OpenAIRE

    2015-01-01

    Introduction: Epicardial fat has been shown to be related not only with clinical atherosclerosis, but also with subclinical atherosclerosis. Objective: To determine the significance of epicardial fat in the diagnosis of coronary atherosclerosis in patients with valvular heart disease. Method: The study included 62 patients scheduled for valve replacement surgery who had previously undergone invasive coronary angiography. Before surgery, epicardial fat measurement was performed by echo...

  15. Thermodynamic study of three pharmacologically significant drugs: Density, viscosity, and refractive index measurements at different temperatures

    Energy Technology Data Exchange (ETDEWEB)

    Iqbal, Muhammad Javed [Department of Chemistry, Quaid-i-Azam University, Islamabad 45320 (Pakistan)], E-mail: mjiqauchem@yahoo.com; Chaudhry, Mansoora Ahmed [Department of Chemistry, Quaid-i-Azam University, Islamabad 45320 (Pakistan)

    2009-02-15

    Measurements of density, viscosity, and refractive index of three pharmacologically significant drugs, i.e. diclofenac sodium, cetrizine, and doxycycline have been carried in aqueous medium at T = (293.15 to 313.15) K. An automated vibrating-tube densimeter, viscometer, and refractometer are used in a concentration range from (7.5) . 10{sup -3} to 25 . 10{sup -3}) mol . kg{sup -1}. The precise density results are used to evaluate the apparent molar volume, partial molar volume, thermal expansion coefficient, partial molar expansivity, and the Hepler's constant. Viscosity results are used to calculate the Jones-Dole viscosity B-coefficient, free energy of activation of the solute and solvent, activation enthalpy, and activation entropy. The molar refractive indices of the drug solutions can be employed to calculate molar refraction. It is inferred from these results that the above mentioned drugs act as structure-making compounds due to hydrophobic hydration of the molecules in the drugs.

  16. Humic-Like Substances from Different Compost Extracts Could Significantly Promote Cucumber Growth

    Institute of Scientific and Technical Information of China (English)

    XU Da-Bing; WANG Qiu-Jun; WU Yun-Cheng; YU Guang-Hui; SHEN Qi-Rong; HUANG Qi-Wei

    2012-01-01

    The effects of direct extracts of compost (DEC),aerated fermentation extracts of compost (AFEC) and non-aerated fermentation extracts of compost (NAFEC) on cucumber growth and the action mechanisms were evaluated based on the structure and activity analysis of humic-like substances.AFEC increased cucumber growth most significantly,followed by DEC and NAFEC,which was insignificant compared to the control treatment.Humic-like substances from compost extracts played an important role in promoting cucumber growth.Application of humic-like substances stimulated auxin-like activity and increased chlorophyll content and nitrogen accumulation in plants.The positive auxin-like activity of humic-like substances could be attributed to the relative distribution of special carbon groups,such as those with a large amount of peptidic and carbohydratic groups or with a low content of phenolic groups.In conclusion,the best growth promotion by application of AFEC was mainly attributed to the humic-like substances in the AFEC.

  17. The significance of different health institutions and their respective contributions of active pharmaceutical ingredients to wastewater.

    Science.gov (United States)

    Herrmann, Manuel; Olsson, Oliver; Fiehn, Rainer; Herrel, Markus; Kümmerer, Klaus

    2015-12-01

    Active pharmaceutical ingredients (APIs) have been frequently found in the environment. It is, however, still not quite clear who is mainly responsible for API emissions. Hospitals have been considered to be the main contributing point sources for wastewater (WW) discharge of APIs. However, recent studies have shown that the contribution of hospitals to the input of APIs into the aquatic environment is quite low. Due to demographic change and the increase of psychiatric diseases, health institutions (HIs) such as psychiatric hospitals and nursing homes are likely to be important sources as well, but no data is available in this respect. This study aims to assess the impact of HIs and to provide a methodology to measure their respective contributions. Drawing on pharmaceutical consumption data for the years 2010, 2011, and 2012, this study identified API usage patterns for a psychiatric hospital (146 beds), a nursing home (286 inhabitants), and a general hospital (741 beds), the latter of which comprises three separate locations. All the HIs are located in two sub-regions of a county district with about 400,000 citizens in southwestern Germany. A selection of neurological drugs was quantified in the sewer of these facilities to evaluate the correlation between consumption and emission. The API contribution of HIs was assessed by comparing the specific consumption in the facilities with the consumption in households, expressed as the emission potential (IEP). The study shows that the usage patterns of APIs in the psychiatric hospital and the nursing home were different from the general hospital. Neurological drugs such as anticonvulsants, psycholeptics, and psychoanaleptics were mainly consumed in the psychiatric hospital and the nursing home (74% and 65%, respectively). Predicted and average measured concentrations in the effluent of the investigated HIs differed mostly by less than one order of magnitude. Therefore, the consumption-based approach is a useful method

  18. Remission of Type 2 Diabetes Mellitus in Patients After Different Types of Bariatric Surgery : A Population-Based Cohort Study in the United Kingdom

    NARCIS (Netherlands)

    Yska, Jan Peter; van Roon, Eric N; de Boer, Anthonius; Leufkens, Hubert G M; Wilffert, Bob; de Heide, Loek J M; de Vries, Frank; Lalmohamed, Arief

    2015-01-01

    Importance: To our knowledge, an observational study on the remission of type 2 diabetes mellitus (T2DM) after different types of bariatric surgery based on data from general practice has not been carried out. Objective: To assess the effect of different types of bariatric surgery in patients with T

  19. Remission of type 2 diabetes mellitus in patients after different types of bariatric surgery : A population-based cohort study in the United Kingdom

    NARCIS (Netherlands)

    Yska, Jan Peter; Van Roon, Eric N.; De Boer, Anthonius; Leufkens, Hubert G M; Wilffert, Bob; De Heide, Loek J M; De Vries, Frank; Lalmohamed, Arief

    2015-01-01

    IMPORTANCE: To our knowledge, an observational study on the remission of type 2 diabetes mellitus (T2DM) after different types of bariatric surgery based on data from general practice has not been carried out. OBJECTIVE: To assess the effect of different types of bariatric surgery in patients with T

  20. Remission of type 2 diabetes mellitus in patients after different types of bariatric surgery : A population-based cohort study in the United Kingdom

    NARCIS (Netherlands)

    Yska, Jan Peter; Van Roon, Eric N.; De Boer, Anthonius; Leufkens, Hubert G M; Wilffert, Bob; De Heide, Loek J M; De Vries, Frank; Lalmohamed, Arief

    2015-01-01

    IMPORTANCE: To our knowledge, an observational study on the remission of type 2 diabetes mellitus (T2DM) after different types of bariatric surgery based on data from general practice has not been carried out. OBJECTIVE: To assess the effect of different types of bariatric surgery in patients with

  1. Remission of Type 2 Diabetes Mellitus in Patients After Different Types of Bariatric Surgery : A Population-Based Cohort Study in the United Kingdom

    NARCIS (Netherlands)

    Yska, Jan Peter; van Roon, Eric N; de Boer, Anthonius|info:eu-repo/dai/nl/075097346; Leufkens, Hubert G M|info:eu-repo/dai/nl/075255049; Wilffert, Bob; de Heide, Loek J M; de Vries, Frank|info:eu-repo/dai/nl/303546670; Lalmohamed, Arief|info:eu-repo/dai/nl/357580680

    2015-01-01

    Importance: To our knowledge, an observational study on the remission of type 2 diabetes mellitus (T2DM) after different types of bariatric surgery based on data from general practice has not been carried out. Objective: To assess the effect of different types of bariatric surgery in patients with

  2. A Comparison of Different Operating Systems for Femtosecond Lasers in Cataract Surgery

    Directory of Open Access Journals (Sweden)

    B. M. Wu

    2015-01-01

    Full Text Available The introduction of femtosecond lasers is potentially a major shift in the way we approach cataract surgery. The development of increasingly sophisticated intraocular lenses (IOLs, coupled with heightened patient expectation of high quality postsurgical visual outcomes, has generated the need for a more precise, highly reproducible and standardized method to carry out cataract operations. As femtosecond laser-assisted cataract surgery (FLACS becomes more commonplace in surgical centers, further evaluation of the potential risks and benefits needs to be established, particularly in the medium/long term effects. Healthcare administrators will also have to weigh and balance out the financial costs of these lasers relative to the advantages they put forth. In this review, we provide an operational overview of three of five femtosecond laser platforms that are currently commercially available: the Catalys (USA, the Victus (USA, and the LDV Z8 (Switzerland.

  3. A Comparison of Different Operating Systems for Femtosecond Lasers in Cataract Surgery.

    Science.gov (United States)

    Wu, B M; Williams, G P; Tan, A; Mehta, J S

    2015-01-01

    The introduction of femtosecond lasers is potentially a major shift in the way we approach cataract surgery. The development of increasingly sophisticated intraocular lenses (IOLs), coupled with heightened patient expectation of high quality postsurgical visual outcomes, has generated the need for a more precise, highly reproducible and standardized method to carry out cataract operations. As femtosecond laser-assisted cataract surgery (FLACS) becomes more commonplace in surgical centers, further evaluation of the potential risks and benefits needs to be established, particularly in the medium/long term effects. Healthcare administrators will also have to weigh and balance out the financial costs of these lasers relative to the advantages they put forth. In this review, we provide an operational overview of three of five femtosecond laser platforms that are currently commercially available: the Catalys (USA), the Victus (USA), and the LDV Z8 (Switzerland).

  4. Different reasons for one significant choice: Factors influencing homeschooling choice in Israel

    Science.gov (United States)

    Guterman, Oz; Neuman, Ari

    2017-06-01

    Homeschooling is an alternative to conventional education in many countries all over the world, though legal regulations vary. This article examines why parents opt for homeschooling. The large body of research on the topic (especially from the United States) points to a variety of reasons for making the choice to homeschool. The most common reasons are of a pedagogical nature, but in many cases they are also family-related. What has not yet been investigated in depth is the relationship between the different reasons for choosing homeschooling and the way in which homeschooling is practised. There is also a lack of research on the relationship between the reasons for choosing homeschooling and the parents' personalities, educational background and attitudes towards both homeschooling in particular and the education system in general. Using a mixed methods design in order to examine these relationships, the authors of this article questioned 62 homeschooling families in Israel. The findings indicate that some parents chose to homeschool for pedagogical reasons only and others for both pedagogical and family-related reasons. Furthermore, the latter group held more positive views of the effect of homeschooling on children - and the mothers in that group, on average, were more educated compared with those who cited pedagogical reasons alone. The reasons for choosing homeschooling were also found to be associated with the character of the homeschooling practice, with families whose reasons were pedagogical only devoting more hours, on average, specifically to studying.

  5. Prognostic significance of lymphovascular space invasion and nodal involvement in intermediate- and high-risk endometrial cancer patients treated with curative intent using surgery and adjuvant radiotherapy.

    Science.gov (United States)

    Narayan, Kailash; Khaw, Pearly; Bernshaw, David; Mileshkin, Linda; Kondalsamy-Chennakesavan, Srinivas

    2012-02-01

    The aim of this study was to assess whether lymphovascular space invasion (LVSI) and nodal status provide adequate prognostic information in comparison with the entire set of traditional prognostic factors in intermediate- and high-risk endometrial cancer patients treated and staged with primary surgery and adjuvant radiotherapy. Three hundred twenty-four previously untreated high-intermediate- and high-risk endometrial cancer patients with FIGO (International Federation of Gynecology and Obstetrics) stage I to IIIC; endometrioid, serous, or clear cell histology; diagnosed between November 1995 and December 2006; who presented to Peter MacCallum Cancer Centre for adjuvant radiotherapy were included in these analyses. All traditionally recognized prognostic factors and newly created 4 pairs of combination of LVSI and nodal status were studied with respect to survival and patterns of failure. The median follow-up time was 4.8 years. Five-year failure-free survival for all patients according to FIGO stage I, II, and III were 87.4%, 89.0%, and 62.4 %, respectively. In multivariable analysis for relapse, positive LVSI had a hazard ratio of 4.9 (P = 0.000), which increased to 8.8 (P = 0.004) in the presence of positive nodes. For overall survival, only LVSI was significant, with a hazard ratio of 3.02 (P = 0.003). In particular, in the presence of LVSI and nodes, histological type, grade, and myometrial invasion were not significant prognosticators for relapse or overall survival. This model enables the separation of good prognosis patients even among poorly differentiated endometrioid, serous, and clear cell carcinoma patients and can be used in simplifying the staging of endometrial cancer and for selecting patients for high-risk endometrial cancer studies.

  6. Biomedical research in france and brazil: an analysis of significant differences and ethical issues

    Directory of Open Access Journals (Sweden)

    Hervé Moizan

    2016-06-01

    Full Text Available At first sight, Brazil and France seem pretty distant from one another, but on the map, they are not separated by the Atlantic Ocean, but by the Oyapock River, located between the state of Amapa and French Guiana (French overseas department, creating a 730 km long international border. If the distance does exist, it is very different when we finely analyze some similarities in the field of biomedical research. France is the biggest country of Western Europe and covers 1/5 of the European Union. Apart from Metropolitan France, the country contains overseas territories, remnants of its colonial past. Over the centuries, France has known several political systems, from Ancient History to the current Republic. According to Ernest Renan, the French nation is more an ideology than a reality, primarily based on “the desire of living together and the wish to highlight our legacy”(1. The tragic attacks of November 2015 and all the reactions over the next days illustrate this. Brazil, discovered by the Portuguese explorer Pedro Alvares during the 16th century, is established on half of South America and is about 16 times bigger than France. This giant does not look to the past but is always moving forward. The concept of nation is really strong throughout the country, as shown by the enthusiasm of soccer players wearing the national auriverde jersey and the National Team supporters. Furthermore, they possess a strong culture of entrepreneurship defined by Stefan Zweig as the legacy of the early colonial era(2. Biomedical research is a human activity which aims to give expected solutions, and sometimes unexpected ones too, to a major and insoluble problem at a given time. This research is based on knowledge and will question it with a scientific approach, spread between what is known today and what will be known tomorrow. Ideally, the point of getting new knowledge is to improve a group of people or the entire population’s health. The researcher is a

  7. The comparison of effects of intrathecal two different levobupivacaine doses in appendectomy surgery

    Directory of Open Access Journals (Sweden)

    Haktan Karaman

    2012-03-01

    Full Text Available Objectives: Spinal anesthesia, especially in the presenceof coexisting diseases is preferred to reduce morbidityand mortality in many surgical practices. In thisstudy, we aimed to compare the motor and sensory blockcharacteristics, hemodynamic parameters, side effectsand surgical and patient comfort, whom underwent appendectomywith spinal anesthesia in two different dosesof levobupivacaine.Material and methods: After Minister of Health ethicalcommittee approval and written consent of the patientswho underwent open appendectomy were obtained, fifhtypatients between the ages of 18-40 with ASA I-II were enrolledin this study. The patients were randomly allocatedto two groups; Group I received 15 mg levobupivacaine0.5% (total 3 ml and Group II received 20 mg levobupivacaine0.5% (total 4 ml Hemodynamic data, surgical andpatient comfort and side effects were also recorded.Results: There were statistically significant differencesbetween the two groups for two segment regression timeof sensory block. Two-segment regression time was longerthe Group II than Group I. In Group II motor blockregression time (Group I 120 ± 40 min, Group II 158 ±54 min was significantly longer (p= p<0.05. There werestatistically significant difference in numbers of side effects(hypotension, bradicardia in Group II than GroupI (p<0.05.Conclusions: This study showed that 15 mg levobupivacainedose provides safe and effective anesthesia for appendectomysurgery. J Clin Exp Invest 2012; 3(1: 33-37

  8. Differences in postoperative morbidity rates, including infection and dry socket, and differences in the healing process after mandibular third molar surgery in patients receiving 1-day or 3-day prophylaxis with lenampicillin.

    Science.gov (United States)

    Yoshii, Takashi; Hamamoto, Yoshihiko; Muraoka, Shigetada; Furudoi, Shungo; Komori, Takahide

    2002-03-01

    The aim of this study was to examine the effect of antibiotic prophylaxis for mandibular third molar surgery from the viewpoint of the duration of administration. A comparative study was conducted on postoperative infection, dry socket, and the healing process in 178 healthy patients receiving 1-day or 3-day prophylaxis with lenampicillin (LAPC; 1.5 g/day). Postoperative infection developed in only 1 (1.1%) of the 91 patients in the 3-day group, while there was no patient with infection in the 87 patients in the 1-day group. Dry socket developed in 8.0% of the 87 patients in the 1-day group and in 7.7% of the 91 patients in the 3-day group. However, the incidence of these complications, in relation to the degree of impaction of the molars, did not significantly differ between the 1-day and 3-day groups. Scores indicating clinical symptoms for the 7 days after surgery also reflected no significant difference between the groups, irrespective of the degree of impaction. These results suggest that 1-day therapy with LAPC in our regimen may at least be recommended as a prophylaxis for mandibular third molar surgery in medically healthy patients.

  9. Geographical variations in the benefit of applying a prioritization system for cataract surgery in different regions of Spain

    Directory of Open Access Journals (Sweden)

    Gutiérrez-Moreno Santiago

    2008-02-01

    Full Text Available Abstract Background In Spain, there are substantial variations in the utilization of health resources among regions. Because the need for surgery differs in patients with appropriate surgical indication, introducing a prioritization system might be beneficial. Our objective was to assess geographical variations in the impact of applying a prioritization system in patients on the waiting list for cataract surgery in different regions of Spain by using a discrete-event simulation model. Methods A discrete-event simulation model to evaluate demand and waiting time for cataract surgery was constructed. The model was reproduced and validated in five regions of Spain and was fed administrative data (population census, surgery rates, waiting list information and data from research studies (incidence of cataract. The benefit of introducing a prioritization system was contrasted with the usual first-in, first-out (FIFO discipline. The prioritization system included clinical, functional and social criteria. Priority scores ranged between 0 and 100, with greater values indicating higher priority. The measure of results was the waiting time weighted by the priority score of each patient who had passed through the waiting list. Benefit was calculated as the difference in time weighted by priority score between operating according to waiting time or to priority. Results The mean waiting time for patients undergoing surgery according to the FIFO discipline varied from 1.97 months (95% CI 1.85; 2.09 in the Basque Country to 10.02 months (95% CI 9.91; 10.12 in the Canary Islands. When the prioritization system was applied, the mean waiting time was reduced to a minimum of 0.73 months weighted by priority score (95% CI 0.68; 0.78 in the Basque Country and a maximum of 5.63 months (95% CI 5.57; 5.69 in the Canary Islands. The waiting time weighted by priority score saved by the prioritization system varied from 1.12 months (95% CI 1.07; 1.16 in Andalusia to 2

  10. Quality of Life Outcomes of Bariatric Surgery: A Systematic Review.

    Science.gov (United States)

    Hachem, Aleeya; Brennan, Leah

    2016-02-01

    Bariatric surgery is often pursued to improve quality of life (QOL). This paper systematically reviews the literature examining QOL following bariatric surgery. Fifteen controlled trials examined changes in QOL in obese (BMI > 30) adults (18–65 years) following bariatric surgery; seven compared bariatric surgery to non-surgical interventions and six compared different types of bariatric surgery. Bariatric surgery resulted in greater improvements in QOL than other obesity treatments. Significant differences in QOL improvements were found between different types of bariatric surgery. QOL improvements were more likely to occur within the first 2 years following surgery, with greater improvements in physical QOL than mental QOL. Bariatric surgery improves QOL. Future research is needed to investigate changes in QOL in different domains in the short- and long-term following bariatric surgery.

  11. Effects of different levels of positive airway pressure on breathing pattern and heart rate variability after coronary artery bypass grafting surgery

    Directory of Open Access Journals (Sweden)

    C.B.F. Pantoni

    2011-01-01

    Full Text Available The application of continuous positive airway pressure (CPAP produces important hemodynamic alterations, which can influence breathing pattern (BP and heart rate variability (HRV. The aim of this study was to evaluate the effects of different levels of CPAP on postoperative BP and HRV after coronary artery bypass grafting (CABG surgery and the impact of CABG surgery on these variables. Eighteen patients undergoing CABG were evaluated postoperatively during spontaneous breathing (SB and application of four levels of CPAP applied in random order: sham (3 cmH2O, 5 cmH2O, 8 cmH2O, and 12 cmH2O. HRV was analyzed in time and frequency domains and by nonlinear methods and BP was analyzed in different variables (breathing frequency, inspiratory tidal volume, inspiratory and expiratory time, total breath time, fractional inspiratory time, percent rib cage inspiratory contribution to tidal volume, phase relation during inspiration, phase relation during expiration. There was significant postoperative impairment in HRV and BP after CABG surgery compared to the preoperative period and improvement of DFAα1, DFAα2 and SD2 indexes, and ventilatory variables during postoperative CPAP application, with a greater effect when 8 and 12 cmH2O were applied. A positive correlation (P < 0.05 and r = 0.64; Spearman was found between DFAα1 and inspiratory time to the delta of 12 cmH2O and SB of HRV and respiratory values. Acute application of CPAP was able to alter cardiac autonomic nervous system control and BP of patients undergoing CABG surgery and 8 and 12 cmH2O of CPAP provided the best performance of pulmonary and cardiac autonomic functions.

  12. Multicolumn spinal cord stimulation for significant low back pain in failed back surgery syndrome: design of a national, multicentre, randomized, controlled health economics trial (ESTIMET Study).

    Science.gov (United States)

    Roulaud, M; Durand-Zaleski, I; Ingrand, P; Serrie, A; Diallo, B; Peruzzi, P; Hieu, P D; Voirin, J; Raoul, S; Page, P; Fontaine, D; Lantéri-Minet, M; Blond, S; Buisset, N; Cuny, E; Cadenne, M; Caire, F; Ranoux, D; Mertens, P; Naous, H; Simon, E; Emery, E; Gadan, B; Regis, J; Sol, J-C; Béraud, G; Debiais, F; Durand, G; Guetarni Ging, F; Prévost, A; Brandet, C; Monlezun, O; Delmotte, A; d'Houtaud, S; Bataille, B; Rigoard, P

    2015-03-01

    Many studies have demonstrated the efficacy of spinal cord stimulation (SCS) for chronic neuropathic radicular pain over recent decades, but despite global favourable outcomes in failed back surgery syndrome (FBSS) with leg pain, the back pain component remains poorly controlled by neurostimulation. Technological and scientific progress has led to the development of new SCS leads, comprising a multicolumn design and a greater number of contacts. The efficacy of multicolumn SCS lead configurations for the treatment of the back pain component of FBSS has recently been suggested by pilot studies. However, a randomized controlled trial must be conducted to confirm the efficacy of new generation multicolumn SCS. Évaluation médico-économique de la STImulation MEdullaire mulTi-colonnes (ESTIMET) is a multicentre, randomized study designed to compare the clinical efficacy and health economics aspects of mono- vs. multicolumn SCS lead programming in FBSS patients with radicular pain and significant back pain. FBSS patients with a radicular pain VAS score≥50mm, associated with a significant back pain component were recruited in 14 centres in France and implanted with multicolumn SCS. Before the lead implantation procedure, they were 1:1 randomized to monocolumn SCS (group 1) or multicolumn SCS (group 2). Programming was performed using only one column for group 1 and full use of the 3 columns for group 2. Outcome assessment was performed at baseline (pre-implantation), and 1, 3, 6 and 12months post-implantation. The primary outcome measure was a reduction of the severity of low back pain (bVAS reduction≥50%) at the 6-month visit. Additional outcome measures were changes in global pain, leg pain, paraesthesia coverage mapping, functional capacities, quality of life, neuropsychological aspects, patient satisfaction and healthcare resource consumption. Trial recruitment started in May 2012. As of September 2013, all 14 study centres have been initiated and 112

  13. Non-invasive prediction of hemodynamically significant coronary artery stenoses by contrast density difference in coronary CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Hell, Michaela M., E-mail: michaela.hell@uk-erlangen.de [Department of Cardiology, University of Erlangen (Germany); Dey, Damini [Department of Biomedical Sciences, Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Taper Building, Room A238, 8700 Beverly Boulevard, Los Angeles, CA 90048 (United States); Marwan, Mohamed; Achenbach, Stephan; Schmid, Jasmin; Schuhbaeck, Annika [Department of Cardiology, University of Erlangen (Germany)

    2015-08-15

    Highlights: • Overestimation of coronary lesions by coronary computed tomography angiography and subsequent unnecessary invasive coronary angiography and revascularization is a concern. • Differences in plaque characteristics and contrast density difference between hemodynamically significant and non-significant stenoses, as defined by invasive fractional flow reserve, were assessed. • At a threshold of ≥24%, contrast density difference predicted hemodynamically significant lesions with a specificity of 75%, sensitivity of 33%, PPV of 35% and NPV of 73%. • The determination of contrast density difference required less time than transluminal attenuation gradient measurement. - Abstract: Objectives: Coronary computed tomography angiography (CTA) allows the detection of obstructive coronary artery disease. However, its ability to predict the hemodynamic significance of stenoses is limited. We assessed differences in plaque characteristics and contrast density difference between hemodynamically significant and non-significant stenoses, as defined by invasive fractional flow reserve (FFR). Methods: Lesion characteristics of 59 consecutive patients (72 lesions) in whom invasive FFR was performed in at least one coronary artery with moderate to high-grade stenoses in coronary CTA were evaluated by two experienced readers. Coronary CTA data sets were acquired on a second-generation dual-source CT scanner using retrospectively ECG-gated spiral acquisition or prospectively ECG-triggered axial acquisition mode. Plaque volume and composition (non-calcified, calcified), remodeling index as well as contrast density difference (defined as the percentage decline in luminal CT attenuation/cross-sectional area over the lesion) were assessed using a semi-automatic software tool (Autoplaq). Additionally, the transluminal attenuation gradient (defined as the linear regression coefficient between intraluminal CT attenuation and length from the ostium) was determined

  14. Randomized clinical trial comparing manual suture and different models of mechanical suture in the mimicking of bariatric surgery in swine

    Directory of Open Access Journals (Sweden)

    Fernandes MA

    2014-02-01

    analysis included the formation of foreign body granuloma in the gastroenteroanastomosis and enteroanastomosis in 88.9% of the swine that underwent manual suture and in none of the swine that underwent stapling. There was also a significant statistical difference among swine from Group A, and those from groups B, C and D regarding the degree of inflammation, being more intense in those swine that underwent manual suture. Conclusion: This study shows that both types of suture promoted proper healing of gastroenteroanastomosis and enteroanastomosis, although there was a higher degree of inflammation and an increased occurrence of foreign body granuloma in swine subjected to manual suture, although there have been similarities in safety, efficiency, and effectiveness between the models of linear mechanical staplers tested during the performance of these anastomoses on swine. Keywords: linear mechanical stapler, stapler, manual suture, surgery, gastroenteroanastomosis, enteroanastomosis, swine, randomized clinical trial

  15. Effect of different anesthesia and analgesia methods on theT lymphocyte subsets, cytokines and stress hormone level in patients with breast cancer surgery

    Institute of Scientific and Technical Information of China (English)

    Yan Ma; Xi-Qiang He; Geng Wang

    2015-01-01

    Objective: To explore the effect of different anesthesia and analgesia methods on the T lymphocyte subsets, cytokines and the levels of the stress hormone in patients with breast cancer surgery.Methods: 86 cases of breast cancer were divided into two groups by random digits table, control group of 43 cases with total intravenous anesthesia, and the observation group of 43 cases with total intravenous anesthesia combined with epidural anesthesia and postoperative underwent analgesia. The T lymphocyte subsets, cytokines and the levels of the stress hormone were detected before and after operation and compared. Results:CD3+, CD4+ and CD4+/CD8+ of the two groups at T1 or T2 were significantly lower than those at T0, and those in the observation group were significantly lower than the control group, and the difference between the two groups has statistical significance. IL-6, CRP and TNF-α levels of the two groups at T1, T2 or T3 were significantly higher than those at T0, and those in the observation group were significantly lower than the control group, and the difference between the two groups has statistical significance. Each index of two groups at T4 were restored to T0, and the differences were no statistically significant. The cortisol levels of two groups at T1 or T2 were significantly increased compared with T0, and the increase in the observation group was less than that of the control group, the difference between the two groups has statistical significance. The cortisol levels of two groups at T4 were restored to T0, and the differences were no statistically significant.Conclusion:Epidural analgesia after the intravenous anesthesia combined with epidural anesthesia for breast cancer cure patients has lighter immunosuppression and stress reaction, has less influence on inflammatory factors, is an ideal anesthesia and analgesia.

  16. Biologic and clinical aspects of integration of different bone substitutes in oral surgery: a literature review.

    Science.gov (United States)

    Zizzari, Vincenzo Luca; Zara, Susi; Tetè, Giulia; Vinci, Raffaele; Gherlone, Enrico; Cataldi, Amelia

    2016-10-01

    Many bone substitutes have been proposed for bone regeneration, and researchers have focused on the interactions occurring between grafts and host tissue, as the biologic response of host tissue is related to the origin of the biomaterial. Bone substitutes used in oral and maxillofacial surgery could be categorized according to their biologic origin and source as autologous bone graft when obtained from the same individual receiving the graft; homologous bone graft, or allograft, when harvested from an individual other than the one receiving the graft; animal-derived heterologous bone graft, or xenograft, when derived from a species other than human; and alloplastic graft, made of bone substitute of synthetic origin. The aim of this review is to describe the most commonly used bone substitutes, according to their origin, and to focus on the biologic events that ultimately lead to the integration of a biomaterial with the host tissue.

  17. Comparison of the Effect of Noise Levels on Stress Response in Two Different Operation Groups in an Orthopedic Surgery Room

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    Hasibe Baytan Yildiz

    2016-09-01

    Full Text Available Aim: The aim of this randomized, single-blinded study was to evaluate the effects of noise on hemodynamic and neuroendocrine stress response by measuring the level of noise in the surgery rooms of patients undergoing knee operations under neuroaxial anesthesia. Gerec ve Yontem: We compared patient responses from two groups of patients: those undergoing knee operations in a surgery room where the noise level (measured in decibels is high, and those undergoing meniscus operations in a surgery room with lower noise levels. The STAI, the State-Trait Anxiety Inventory (STAI-1, and the anxiety test (STAI-2wereperformed at preoperative and postoperative periods. 20 ml of blood sample was taken for basal, intraoperative 30th minute, and postoperative 1st hour measurements. Systolic, diastolic, and mean arterial blood pressures were found to be higher in the high noise level group. ACTH levels were increased during the early postoperative period and became normal during the late postoperative period in the high noise level group whereas ACTH levels were significantly decreased in the low-noise level group. Basal cortisol levels were significantly higher in the high noise level group. HCRP, an inflammatory response mediator was found to be decreased in both groups. Early and late blood glucose levels were significantly higher in the high noise group. There was a greater increase in early and late blood glucose levels in the high noise group. In the postoperative period, although the state-trait anxiety inventory (STAI-2 levels being higher in patients subject to noisier environment determines how people feel independent of the conditions and state they are in, this result made us consider that the noise the patients were subjected to in the intraoperative period may cause a stress response. Discussion: As a result we believe that standard noise levels should be achieved by reducing the factors causing high noise levels in the operating room. This will

  18. A Q Study of Music Teachers' Attitudes towards the Significance of Individual Differences for Teaching and Learning in Music

    Science.gov (United States)

    Hewitt, Allan

    2006-01-01

    Classroom teachers' beliefs and attitudes regarding the role and significance of individual differences have received relatively little attention in the literature to date, notwithstanding the well-documented importance both of teachers' beliefs and factors of individual difference for the learning and teaching process. The purpose of this study…

  19. Female Gender and Differences in Outcome after Isolated Coronary Artery Bypass Graft Surgery: Does Age Play a Role?

    Directory of Open Access Journals (Sweden)

    Rawa Arif

    Full Text Available Female gender is a known risk factor for early and late mortality after coronary artery bypass graft surgery (CABG. Higher age of women at operation may influence outcome, since age per se is also an important risk factor. The purpose of our study was to analyze possible gender differences in outcome after isolated CABG in different age groups to delineate the impact of female gender and age.All patients over 60 years of age undergoing isolated CABG at our department during 2001 and 2011 were included and categorized by age into sexagenarians (2266, 16.6% women, septuagenarians (2332, 25.4% women and octogenarians (374, 32% women and assessed by gender for 30-day and 180-day mortality.Thirty-day mortality was significantly higher in women only amongst septuagenarians (7.1 vs. 4.7%, p = 0.033. Same differences apply for 180-day mortality (12.3 vs. 8.2%, p = 0.033 and estimated one-year survival (81.6 ± 4.2 vs. 86.9 ± 2.2%, p = 0.001. Predictive factors for 30-day mortality of septuagenarian were logistic EuroSCORE (ES (p = 0.003, perioperative myocardial infarction (MI (p<0.001, pneumonia (p<0.001, abnormal LV-function (p<0.04 and use of LIMA graft (p<0.001, but not female gender. However, female gender was found to be an independent predictor for 180-day mortality (HR 1.632, p = 0.001 in addition to ES, use of LIMA graft, perioperative MI, pneumonia and abnormal LV function (HR 1.013, p = 0.004; HR 0.523, p<0.001; HR 2.710, p<0.001; HR 3.238, p<0.001; HR 2.013, p<0.001.Women have a higher observed probability of early death after CABG in septuagenarians. However, female gender was not found to be an independent risk factor for 30-day, but for 180-day survival. Therefore, reduction of high impact risk factors such as perioperative MI and enhancement of LIMA use should be future goals. In view of our findings, decision for surgical revascularization should not be based on gender.

  20. Nutritional Risk in Major Abdominal Surgery: Protocol of a Prospective Observational Trial to Evaluate the Prognostic Value of Different Nutritional Scores in Pancreatic Surgery

    OpenAIRE

    Probst, Pascal; Haller, Sebastian; Dörr-Harim, Colette; Bruckner, Thomas; Ulrich,Alexis; Hackert, Thilo; Diener, Markus K; Knebel, Phillip

    2015-01-01

    Background The influence of patients’ preoperative nutritional status on their clinical outcome has already been proven. Therefore, patients with malnutrition are in need of additional therapeutic efforts. However, for pancreatic surgery, evidence suggesting the adequacy of existing nutritional assessment scores to estimate malnutrition associated with postoperative outcome is limited. Objective The aim of the observational trial “Nutritional Risk in Major Abdominal Surgery (NURIMAS) Pancreas...

  1. Practice variation in treatment of suspected asymptomatic bacteriuria prior to cardiac surgery: are there differences in postoperative outcome? A retrospective cohort study.

    Science.gov (United States)

    de Lange, Marije P; Sonker, Uday; Kelder, Johannes C; de Vos, Rien

    2016-06-01

    It is unclear whether postoperative infections can be prevented by treating asymptomatic bacteriuria, or whether, on the other hand, such treatment will increase the risk of more serious infection by pathogenic bacteria different from the ones causing bacteriuria. This study aimed to support future treatment decisions for preoperative cardiothoracic surgery patients with asymptomatic bacteriuria, by examining current preoperative practice, in relation to postoperative outcome. A retrospective cohort study was conducted. All patients who underwent cardiothoracic surgery in 2011-2013 using extracorporeal circulation in St. Antonius Hospital Nieuwegein, and who preoperatively had nitrituria and/or leucocyturia were included. Exclusion criteria were C-reactive protein level higher than 10 mg/l, emergency surgery, critical preoperative state and/or antibiotic treatment because of other infections. Outcomes were postoperative infections and length of stay. Furthermore, we compared culture results of preoperative urine with postoperative infection sites in order to study the hypothesis of haematogenous spread. One thousand and two patients with leucocyturia or nitrituria were eligible, of whom 3.9% had been treated with antibiotics preoperatively (AB+). Of the 96.1% of patients who had not been treated (AB-), 8.3% had an infection postoperatively, compared with 5.1% in the treatment (AB+) group. This was not statistically significant {odds ratio, corrected for EuroSCORE, 0.53 [95% confidence interval (CI) 0.12-2.24, P = 0.39]}. Length of stay, corrected for EuroSCORE, between the treated (AB+) and the non-treated (AB-) group did not differ, with a hazard ratio of 1.05 (95% CI 0.63-1.75, P = 0.85). As regards bacterial culture results, none of patients not treated with antibiotics preoperatively (AB-) seemed to have a postoperative infection due to haematogenous spread of bacteria from the urinary tract present preoperatively. The risk of haematogenous spread of bacteria

  2. The effectiveness of different root debridement modalities in open flap surgery.

    Science.gov (United States)

    Huerzeler, M B; Einsele, F T; Leupolz, M; Kerkhecker, U; Strub, J R

    1998-03-01

    It is unclear what degree of roughness or smoothness result from use of hand instruments alone in comparison to the use of hand instruments in combination with other aids and how it may effect the grade of cleanliness. The aim of this study was to determine in vivo whether the combination of hand instruments with other aids can increase the effectiveness of root debridement. 11 patients with holpless 4 mandibular incisors were involved in this study. After elevating a lingual and buccal mucoperiosteal flap, the 4 incisors were randomly treated with either: (1) no treatment (control); (2) 5-min scaling (method 1); (3) 4-min scaling and 1 min instrumentation with a perio-diamond bur (15 microm) (method 2); (4) 3-min scaling, 1-min instrumentation with a perio-diamond bur (15 microm) and 1 min with an air abrasive system (method 3). The cleanliness of the surface was determined using the method of Eschler and -Rapley. The degree of roughness (Ra and Rt) were measured with a laser beam (computer supported optical surface sensor system). In addition, an SEM analysis was performed. With regard to the remaining calculus (surface cleanliness), method 3 yielded significantly better results than the other 2 methods. The roughness analyses also exhibited that method 3 is superior to methods 1 and 2. The qualitative results of the SEM investigations demonstrated the most homogeneous and smooth surfaces with method 3. Root debridement in vivo was most significant using a combination of different treatment modalities (i. e., curettes, perio-diamond bur and air abrasive system).

  3. Significant negative impact of adjuvant chemotherapy on Health-Related Ouality of Life (HR-OoL) in women with breast cancer treated by conserving surgery and postoperative 3-D radiotherapy. A prospective measurement

    Energy Technology Data Exchange (ETDEWEB)

    Galalae, R.M.; Michel, J.; Kimmig, B. [Clinic for Radiation Therapy (Radiooncology), Univ. Hospital Schleswig-Holstein, Campus Kiel (Germany); Siebmann, J.U.; Kuechler, T.; Eilf, K. [Dept. of General and Thoracic Surgery/Reference Center on Quality of Life in Oncology, Univ. Hospital Schleswig-Holstein, Campus Kiel (Germany)

    2005-10-01

    Purpose: to prospectively assess health-related quality of life (HR-QoL) in women after conserving surgery for breast cancer during/after postoperative 3-D radiotherapy. Patients and methods: 109 consecutively treated patients were analyzed. HR-QoL was assessed at initiation (t1), end (t2), and 6 weeks after radiotherapy (t3) using the EORTC modules QLQ-C30/BR23. Patients were divided into three therapy groups. Group I comprised 41 patients (radiotherapy and adjuvant chemotherapy), group II 45 patients (radiotherapy and adjuvant hormonal therapy), and group III 23 patients (radiotherapy alone). Reliability was tested. Scale means were calculated. Univariate (ANOVA) and multivariate (MANCOVA) analyses were performed. Results: reliability testing revealed mean Cronbach's {alpha} > 0.70 at all measurement points. ANOVA/MANCOVA statistics revealed significantly better HR-QoL for patients in group II versus I. Patients receiving radiotherapy alone (group III) showed the best results in HR-QoL. However, scale mean differences between groups II and III were not significant. Conclusion: HR-QoL measurement using EORTC instruments during/after radiotherapy is reliable. Adjuvant chemotherapy significantly lowered HR-QoL versus hormones or radiotherapy alone. Chemotherapy patients did not recover longitudinally (from t1 to t3). (orig.)

  4. 周六手术在医院运行管理中的价值和意义%Value and Significance of Saturday Surgery in Hospital Management

    Institute of Scientific and Technical Information of China (English)

    李鹏程; 游潮; 宁宁; 陈茂君

    2011-01-01

    目的 通过开展周六手术,缩短病人平均术前等待日及平均住院日.在保证医疗质量的前提下,达到提高效率,增加产能的目的.方法 在多部门协作的基础上,开展周六手术,改变原有人力配置方式和手术流程,以配合周六手术的进行.结果 手术流程再造后,与之前同期相比术前等待日缩短25.00%,月平均手术台次增加12.35%,病人平均住院日降低9.22%.结论 开展周六手术,能缩短患者平均住院日和术前等待日,为患者节约宝贵的时间和金钱,在一定程度上解决了患者看病难、看病贵的问题,提高了医院的工作效率.%Objective To perform more Saturday operations to cut waiting lists for elective surgery and diminish average length of stay. To enhance efficiency and improve health outcomes based on ensuring the healthcare quality. Methods Based on the corporation of multiple departments, a range of new measures was introduced to reduce waiting times for surgery, which was consisted of optimizing the resource allocation and re-organizing the surgical algorithms. Results After operation process reengineering, surgery waiting time decreased 25.00%. The number of surgeries per month increased 12.35%. And patients' average length of stay decreased 9.22%. Conclusion The implementation of weekend operation greatly diminished the median waiting time for surgery. So it can save time and money for patients. Therefore, "too difficult to see doctors and too expensive to see doctors" can be solved to some extend, and the working efficiency of hospital can be enhanced.

  5. Endodontic surgery using 2 different magnification devices: preliminary results of a randomized controlled study.

    Science.gov (United States)

    Taschieri, Silvio; Del Fabbro, Massimo; Testori, Tiziano; Francetti, Luca; Weinstein, Roberto

    2006-02-01

    The introduction of microsurgical instruments and magnification devices has brought advantages in root-end management and the application of root-end filling materials. The main purpose of this prospective clinical study was to monitor the outcome of ultrasonic root-end preparation using magnification loupes or an endoscope. Tooth location and the presence of post restoration were also examined as potentially affecting the outcome. Teeth treated surgically showed a periradicular lesion of strictly endodontic origin. A total of 59 patients were included in the study, according to specific selection criteria. Following the reflection of a full mucoperiosteal tissue flap, residual soft tissues were curetted, root ends were resected, and root-end cavities were prepared ultrasonically with a zirconium nitrate tip, and zinc oxide EBA-reinforced cement root-end fillings were placed. Thirty-two root-end management procedures were performed using magnification loupes and 39 using an endoscope. All cases followed for a period of 1 year were classified into 3 groups (success, uncertain healing, and failure) according to radiographic and clinical criteria. Of the 71 teeth evaluated at 1-year follow-up, 67 teeth (92.95%) successfully healed, 3 teeth had uncertain healing, and 2 failed. In the group using endoscopy, 94.9% of successful healing was achieved, while for the other group, 90.6% was recorded. We found no statistically significant differences in treatment results related to the arch (P = .20), post restoration (P = .21), or type of magnification device (P = .08). In the present study, adherence to a strict endodontic surgical protocol and the use of modern surgical endodontic procedures, together with visual magnifications, resulted in an overall high success rate.

  6. An Examination Of Bahamian Respondents’ Task And Relationship Orientations: Do Males Have A Significantly Different Score Than Females?

    Directory of Open Access Journals (Sweden)

    Bahaudin G. Mujtaba

    2011-01-01

    Full Text Available Leaders get things done through building relationships and getting tasks done in a timely manner. The focus on leadership of people in different cultures are of great importance to managers since they want tasks done in a timely manner and healthy relationships maintained with their vendors and customers. To explore the orientation of respondents in the Bahamas, this research focused on the differences of male and female Bahamian respondents. From the responses of 211 individuals in Nassau, it appears that Bahamians have significantly different scores on the relationship and task orientations. They are more relationship-oriented. The responses of 46 males and 165 females demonstrate significant differences based on gender. The information is useful for international managers and expatriates working in the Bahamas. Suggestions for future research and implications are presented.

  7. Competition between Eurasian red and introduced Eastern grey squirrels: the energetic significance of body-mass differences.

    OpenAIRE

    Bryce, J. M.; Speakman, J.R.; Johnson, P J; Macdonald, D W

    2001-01-01

    Daily energy expenditure (DEE) was measured in sympatric populations of red and grey squirrels using the doubly labelled water technique. Grey squirrels had significantly higher DEEs than red squirrels. However, the difference between the species was not separable from the effects of body mass on DEE. The DEEs of both species were in accordance with published allometric predictions incorporating body mass and ambient temperature. The differences in energetic requirements and social dominance,...

  8. Lack of difference between continuous versus intermittent heparin infusion on maintenance of intra-arterial catheter in postoperative pediatric surgery: a randomized controlled study

    Directory of Open Access Journals (Sweden)

    Maria Carolina Witkowski

    2013-12-01

    Full Text Available OBJECTIVE: To compare two systems of arterial catheters maintenance in postoperative pediatric surgery using intermittent or continuous infusion of heparin solution and to analyze adverse events related to the site of catheter insertion and the volume of infused heparin solution. METHODS: Randomized control trial with 140 patients selected for continuous infusion group (CIG and intermittent infusion group (IIG. The variables analyzed were: type of heart disease, permanence time and size of the catheter, insertion site, technique used, volume of heparin solution and adverse events. The descriptive variables were analyzed by Student's t-test and the categorical variables, by chi-square test, being significant p<0.05. RESULTS: The median age was 11 (0-22 months, and 77 (55% were females. No significant differences between studied variables were found, except for the volume used in CIG (12.0±1.2mL/24 hours when compared to IIG (5.3±3.5mL/24 hours with p<0.0003. CONCLUSIONS: The continuous infusion system and the intermittent infusion of heparin solution can be used for intra-arterial catheters maintenance in postoperative pediatric surgery, regardless of patient's clinical and demographic characteristics. Adverse events up to the third postoperative day occurred similarly in both groups. However, the intermittent infusion system usage in underweight children should be considered, due to the lower volume of infused heparin solution [ClinicalTrials.gov Identifier: NCT01097031].

  9. Lack of difference between continuous versus intermittent heparin infusion on maintenance of intra-arterial catheter in postoperative pediatric surgery: a randomized controlled study

    Science.gov (United States)

    Witkowski, Maria Carolina; de Moraes, Maria Antonieta P.; Firpo, Cora Maria F.

    2013-01-01

    OBJECTIVE: To compare two systems of arterial catheters maintenance in postoperative pediatric surgery using intermittent or continuous infusion of heparin solution and to analyze adverse events related to the site of catheter insertion and the volume of infused heparin solution. METHODS: Randomized control trial with 140 patients selected for continuous infusion group (CIG) and intermittent infusion group (IIG). The variables analyzed were: type of heart disease, permanence time and size of the catheter, insertion site, technique used, volume of heparin solution and adverse events. The descriptive variables were analyzed by Student's t-test and the categorical variables, by chi-square test, being significant p<0.05. RESULTS: The median age was 11 (0-22) months, and 77 (55%) were females. No significant differences between studied variables were found, except for the volume used in CIG (12.0±1.2mL/24 hours) when compared to IIG (5.3±3.5mL/24 hours) with p<0.0003. CONCLUSIONS: The continuous infusion system and the intermittent infusion of heparin solution can be used for intra-arterial catheters maintenance in postoperative pediatric surgery, regardless of patient's clinical and demographic characteristics. Adverse events up to the third postoperative day occurred similarly in both groups. However, the intermittent infusion system usage in underweight children should be considered, due to the lower volume of infused heparin solution [ClinicalTrials.gov Identifier: NCT01097031]. PMID:24473958

  10. Different surgical strategies for chronic pancreatitis significantly improve long-term outcome: a comparative single center study

    Directory of Open Access Journals (Sweden)

    Hildebrand P

    2010-08-01

    Full Text Available Abstract Objective In general, chronic pancreatitis (CP primarily requires conservative treatment. The chronic pain syndrome and complications make patients seek surgical advice, frequently after years of progression. In the past, surgical procedures involving drainage as well as resection have been employed successfully. The present study compared the different surgical strategies. Patients and Methods From March 2000 until April 2005, a total of 51 patients underwent surgical treatment for CP at the Department of surgery, University of Schleswig-Holstein, Campus Lübeck. Out of those 51 patients, 39 (76.5% were operated according to the Frey procedure, and in 12 cases (23.5% the Whipple procedure was performed. Patient data were documented prospectively throughout the duration of the hospital stay. The evaluation of the postoperative pain score was carried out retrospectively with a validated questionnaire. Results Average operating time was 240 minutes for the Frey group and 411 minutes for the Whipple group. The medium number of blood transfusions was 1 in the Frey group and 4.5 in the Whipple group. Overall morbidity was 21% in the Frey group and 42% in the Whipple group. 30-day mortality was zero for all patients. During the median follow-up period of 50 months, an improvement in pain score was observed in 93% of the patients of the Frey group and 67% of the patients treated according to the Whipple procedure. Conclusion The results show that both the Frey procedure as well as partial pancreaticoduodenectomy are capable of improving chronic pain symptoms in CP. As far as later endocrine and exocrine pancreatic insufficiency is concerned, however, the extended drainage operation according to Frey proves to be advantageous compared to the traditional resection procedure by Whipple. Accordingly, the Frey procedure provides us with an organ-preserving surgical procedure which treats the complications of CP sufficiently, thus being an

  11. Gender differences and regionalization of the cultural significance of wild mushrooms around La Malinche volcano, Tlaxcala, Mexico.

    Science.gov (United States)

    Montoya, A; Torres-García, E A; Kong, A; Estrada-Torres, A; Caballero, J

    2012-01-01

    The purpose of this study was to determine the cultural significance of wild mushrooms in 10 communities on the slopes of La Malinche volcano, Tlaxcala. The frequency and order of mention of each mushroom species in interviews of 200 individuals were used as indicators of the relative cultural significance of each species. A X(2) analysis was used to compare the frequency of mention of each species between males and females, and a Mann-Whitney U test was used to compare the difference in the total number of fungi mentioned by either gender. Traditional names for mushroom species were documented and frequency of mention assessed through multivariate statistics. The fungi with highest frequency of mention were Amanita basii, Lyophyllum decastes, Boletus pinophilus, Gomphus floccosus and Cantharellus cibarius complex. We found significant differences in the frequency of mention of different fungi by males and females but no significant difference was found for the total number of fungi mentioned by either gender. Principal component analysis suggested a cultural regionalization of La Malinche volcano communities based on preferences for consumption and use of traditional names. We observed two groups: one formed by communities on the eastern part of the volcano (with mixed cultures) and the other including communities on the western slope (ethnic Nahua towns). San Isidro Buensuceso is the most distinct community, according to the criteria in this study.

  12. The effect of different drugs on sevoflurane emergence agitation in pediatric patients undergoing hypospadias repair surgery

    Directory of Open Access Journals (Sweden)

    Manal M. Rashad

    2014-04-01

    Conclusion: The use of propofol or fentanyl just before the discontinuation of sevoflurane reduces the incidence of emergence agitation in children, on the other hand fentanyl was accompanied with a significantly longer PACU duration and higher incidence of vomiting.

  13. Expression and significance of S100P, CD147, and OCT4 in different prostate cancer tissue TNM stages.

    Science.gov (United States)

    Wang, Q; Zhang, J G; Wang, W

    2015-06-18

    The aim of this project was to investigate the expression and significance of S100P, CD147, and OCT4 in prostate cancer tissue at different TNM stages. We enrolled 54 patients with prostate cancer, 40 with benign prostatic hyperplasia, and 20 subjects with normal prostates. S100P, CD147, and OCT4 were detected by immunohistochemistry. The positive rate of S100P detection was 18.52% in prostate cancer tissues, significantly lower than in normal and benign prostate hyperplasia tissues (P ˂ 0.05). The positive expression rate of CD147 and OCT4 were 100 and 77.38% in prostate cancer tissue, respectively, both markedly higher than in normal and benign prostate hyperplasia tissue (P ˂ 0.05). The positive rate of S100P in stage V was 0, which was significantly lower than in stages I (37.50%) and II (35.71%) (P ˂ 0.05). OCT4 expression in stages III (86.67%) and V (94.12%) was higher than in stage I (37.50%). The positive rate of S100P in patients with distant metastasis was 4%, which was significantly lower than that in patients without metastases (P ˂ 0.05). In contrast, the positive rate of OCT4 in patients with distant metastasis was 92%. S100P, CD147, and OCT4 expression in prostate cancer patients with different degrees of differentiation had no significant difference (P > 0.05). Overall, our results demonstrated that S100P expression in prostate cancer tissue was significantly decreased, whereas CD147 and OCT4 expression was increased. Their expression levels were closely associated with TNM stage and distant metastasis, but were not related to the degree of differentiation.

  14. Differences between men and women in hospital mortality associated with coronary artery bypass graft surgery. The Northern New England Cardiovascular Disease Study Group.

    Science.gov (United States)

    O'Connor, G T; Morton, J R; Diehl, M J; Olmstead, E M; Coffin, L H; Levy, D G; Maloney, C T; Plume, S K; Nugent, W; Malenka, D J

    1993-11-01

    A prospective study of patients undergoing coronary artery bypass graft surgery (CABG) was conducted to examine differences in hospital mortality by sex. Outcome data on 3055 CABG patients undergoing operation between 1987 and 1989 were examined for differences in patient, disease, and treatment factors. Odds ratios (OR), risk differences, and 95% confidence intervals (CI95%) were calculated. Mortality rates for women (7.1%) and men (3.3%) differed, the OR (women versus men) being 2.23 (CI95%, 1.58 to 3.15). Women were older, more often diabetic, and had more urgent or emergent surgery; adjustment yielded an OR (women versus men) of 1.75 (CI95%, 1.17 to 2.63). Body surface area (BSA) was associated with risk of death in both sexes (P = .007) and positively associated with coronary artery luminal diameters. After adjustment for BSA, sex was no longer significantly associated with mortality (OR [women versus men] of 1.18; CI95%, 0.72 to 1.95). Internal mammary artery (IMA) grafting was performed less frequently among women than men (64.8% versus 78.4%, P < .001). Smaller BSA and absence of IMA grafting were each associated with increased risk of death (RD) from heart failure. Risk of death from heart failure (RD [women minus men] = 2.05; CI95%, 0.89 to 3.22) and hemorrhage (RD [women minus men] = 0.63; CI95%, 0.13 to 1.13) was greater among women; these accounted for 71.1% of the sex-specific difference in mortality rates. Excess risk of hospital mortality among women having CABG was largely the consequence of death from heart failure and, to a lesser extent, from hemorrhage. Smaller BSA (probably because of its association with coronary artery luminal diameter) and the absence of IMA grafting were each associated with increased risk of death from heart failure.

  15. Illness perceptions in the context of differing work participation outcomes: exploring the influence of significant others in persistent back pain

    Directory of Open Access Journals (Sweden)

    Brooks Joanna

    2013-01-01

    Full Text Available Abstract Background Previous research has demonstrated that the significant others of individuals with persistent back pain may have important influences on work participation outcomes. The aim of this study was to extend previous research by including individuals who have remained in work despite persistent back pain in addition to those who had become incapacitated for work, along with their significant others. The purpose of this research was to explore whether the illness beliefs of significant others differed depending on their relative’s working status, and to make some preliminary identification of how significant others may facilitate or hinder work participation for those with persistent back pain. Methods Interviews structured around the Illness Perception Questionnaire (chronic pain version were conducted with back pain patients recruited from a hospital pain management clinic along with their significant others. Some patients had remained in work despite their back pain; others had ceased employment. Data were analysed using template analysis. Results There were clear differences between beliefs about, and reported responses to, back pain symptoms amongst the significant others of individuals who had remained in employment compared with the significant others of those who had ceased work. Three overarching themes emerged: perceived consequences of back pain, specific nature of employment and the impact of back pain on patient identity. Conclusions Significant others of employed individuals with back pain focused on the extent to which activity could still be undertaken despite back pain symptoms. Individuals out of work due to persistent back pain apparently self-limited their activity and were supported in their beliefs and behaviours by their significant others. To justify incapacity due to back pain, this group had seemingly become entrenched in a position whereby it was crucial that the individual with back pain was perceived

  16. ama1 Genes of Sympatric Plasmodium vivax and P. falciparum from Venezuela Differ Significantly in Genetic Diversity and Recombination Frequency

    OpenAIRE

    Ord, RL; Tami, A; Sutherland, CJ

    2008-01-01

    BACKGROUND: We present the first population genetic analysis of homologous loci from two sympatric human malaria parasite populations sharing the same human hosts, using full-length sequences of ama1 genes from Plasmodium vivax and P. falciparum collected in the Venezuelan Amazon. METHODOLOGY/PRINCIPAL FINDINGS: Significant differences between the two species were found in genetic diversity at the ama1 locus, with 18 distinct haplotypes identified among the 73 Pvama1 sequences obtained, compa...

  17. Frequencies of polymorphisms associated with BSE resistance differ significantly between Bos taurus, Bos indicus, and composite cattle

    Directory of Open Access Journals (Sweden)

    Seabury Christopher M

    2008-09-01

    Full Text Available Abstract Background Transmissible spongiform encephalopathies (TSEs are neurodegenerative diseases that affect several mammalian species. At least three factors related to the host prion protein are known to modulate susceptibility or resistance to a TSE: amino acid sequence, atypical number of octapeptide repeats, and expression level. These factors have been extensively studied in breeds of Bos taurus cattle in relation to classical bovine spongiform encephalopathy (BSE. However, little is currently known about these factors in Bos indicus purebred or B. indicus × B. taurus composite cattle. The goal of our study was to establish the frequency of markers associated with enhanced susceptibility or resistance to classical BSE in B. indicus purebred and composite cattle. Results No novel or TSE-associated PRNP-encoded amino acid polymorphisms were observed for B. indicus purebred and composite cattle, and all had the typical number of octapeptide repeats. However, differences were observed in the frequencies of the 23-bp and 12-bp insertion/deletion (indel polymorphisms associated with two bovine PRNP transcription regulatory sites. Compared to B. taurus, B. indicus purebred and composite cattle had a significantly lower frequency of 23-bp insertion alleles and homozygous genotypes. Conversely, B. indicus purebred cattle had a significantly higher frequency of 12-bp insertion alleles and homozygous genotypes in relation to both B. taurus and composite cattle. The origin of these disparities can be attributed to a significantly different haplotype structure within each species. Conclusion The frequencies of the 23-bp and 12-bp indels were significantly different between B. indicus and B. taurus cattle. No other known or potential risk factors were detected for the B. indicus purebred and composite cattle. To date, no consensus exists regarding which bovine PRNP indel region is more influential with respect to classical BSE. Should one particular

  18. [Clinical Significance of the Bone Marrow Morphological Differences in the Differential Diagnosis of Megaloblastic Anemia and Refractory Anemia].

    Science.gov (United States)

    Wu, Min; Li, Yi-Gui; Nie, Da-Nian; Long, Jing

    2016-06-01

    To investigate the clinical significance of bone marrow morphological differences in the differential diagnosis of megaloblastic anemia (MM) and refractory anemia (R4). A total of 60 anemia patients selected from our hospital between April 2004 and April 2015 were divided into MA group (30 cases) and RA group (30 cases) in accordance with their clinical diagnosis. Clinical manifestations, results of bone marrow morphology test, blood examination, peripheral blood smear, erythroid megaloblastic variability rate and nucleated red blood cell level in the 2 groups were compared and analyzed. Incidence of fever, hemorrhage, digestive reaction, splenomegaly and fatigue as well as hemoglobin level, platelets and white blood cell counts in patients of MA group were similar to those of RA group, there was no statistically significant difference between 2 groups (P>0.05). The percentages of dysplastic hematopoiesis in erythroid cells, granulocytic cells, magakaryoajtic cells, the PAS-positive rate and red blood cell distribution in the MA patients were obviously lower than those in the RA patients, while the erythroid megaloblastic variability rate (90%) in MA group was obviously higher than that in RA patients (10%) and with statistically significant difference (P0.05). Most of clinical manifestations and peripheral blood smear results are consistent in MA patients and RA patients, bone marrow morphology detection in RA group should be focused on lymphocytoid micromegakaryocytes, while the erythroid megaloblastic cell body is the focus in MA group, PAS can be used as a diagnostic criteria.

  19. Bariatric Surgery

    Science.gov (United States)

    ... Metabolic and Bariatric Surgery MedlinePlus What is bariatric surgery? Bariatric surgery helps people who are very obese to ... What are the endocrine-related benefits of bariatric surgery? Bariatric surgery and the weight loss that results can: ...

  20. Use of Lactated Ringer’s solution does not eliminate the risk of strong ion difference-related metabolic acidosis following on-pump cardiac surgery.

    Science.gov (United States)

    Jovaisa, T; Vicka, V; Linkaitė, G; Guseinovaitė, J; Ringaitienė, D; Norkienė, I

    2016-01-01

    There is a growing interest in the effects of plasma sodium levels on postoperative outcomes. A trend of using balanced crystalloid solutions is based on the extensive data on chloride and the strong ion difference-related acidosis. However, effects of sodium are often overlooked in this context. The aim of the study was to establish the effects of the routine use of Lactated Ringer’s Solution (RL) on postoperative changes in sodium concentrations and whether these changes result in metabolic acidosis. We performed database analysis of 358 consecutive elective on-pump cardiac surgery cases in a tertiary referral university hospital. Approval from the institutional ethics committee was obtained for this study. Intraoperative fluid balance was 2726±1073 ml and the total volume of intravenous infusions in the first 24 hours was 5865 (±1073) ml, 95% of which was RL; 58% of the patients had metabolic acidosis with a base excess below (–)2 mmol L–1 on arrival at the intensive care unit. There was a significant correlation between a strong ion difference and base excess (p less than 0.01). A significant improvement in metabolic acidosis was noted within the first 24 hours, from a base excess of (–)2.49±2.8 to 0.32±2.6 mmol L–1 (p less than 0.001). All of the improvement in the base excess is explained by a change in the strong ion difference from the mean value of 31±4.3 to 34.2±3.6 mmol L–1 (p less than 0.001). Changes in the strong ion difference were primarily driven by changes in the serum sodium concentration, which were three-fold higher compared to those of chloride [–2.36 (±2.6) mmol L–1 (p less than 0.001) and 0.84 (±3.2) mmol L–1, respectively (p = 0.01)]. In conclusion, our data confirm that there is a direct correlation between a strong ion difference and base excess following on-pump cardiac surgery. The use of RL prevented significant hyperchloraemia, but did not eliminate the risk of strong ion difference-related metabolic acidosis. The

  1. 腰椎磁共振在腰椎间盘突出症术后复发诊断中的意义%The significance of lumbar MRI in the diagnosis of recurrented lumbar disc herniation after surgery

    Institute of Scientific and Technical Information of China (English)

    田融; 孙天威; 神兴勤; 张学利; 贾宇涛; 胡炜

    2014-01-01

    Objective To retrospectively evaluate the clinical evaluation of preoperative lumbar T2 sagittal MRI image in predicting the recurrent lumbar disc herniation (RLDH).Methods Between January 2009 and April 2011,28 patients were diagnosed as recurrent L4-5 disc herniation within 2.5 years after surgery,and 25 of them were included in the study as relapse group.At the same time,selected 25 patients implemented the same surgical methods in the same level as a control group randomly,they were all with good to excellent result and the follow-up time was at least 2.5 years.There was no statistical significance between the two groups in gender,age and body mass index(BMI) (P > 0.05).The lumbar MRI image of two groups of patients before surgery were collected and analyzed,with the disc degeneration grade classified.The x2 test was used to analyzed the difference of degeneration between the two groups of patients before surgery.Rank correlation analysis evaluated the correlation between disc degeneration and the period of time from the first operation to the recurrence.Results In terms of preoperative lumbar disc degeneration,there were 22 cases of low-grade disc degeneration and 3 cases of advanced disc degeneration in the relapse group and 5 cases and 20 cases respectively in the control group.there was significant difference between two groups (x2 =23.27,P < 0.05),low-grade disc degeneration (grades Ⅰ and Ⅲ) was significantly more frequent in the relapse group than in the control group.The patients with low-grade disc degeneration had a higher risk of recurrence,that was the risk of recurrent disc herniation increased by a factor of 4.4 from advanced disc degeneration to low-grade disc degeneration (OR =4.4,95% CI:1.983-9.765,P <0.05).In cases of recurrence,the time interval between primary surgery and the recurrence of the patient with advanced disc degeneration was longer compared with low-grade disc degeneration (r =0.733,P < 0.05).Conclusions Preoperative

  2. Different values of urinary fractionated metanephrines after unilateral adrenalectomy for pheochromocytoma according to time intervals after surgery.

    Science.gov (United States)

    Cho, Yoon Y; Kim, Young N; Kim, Jung-Han; Jeong, Byong C; Lee, Soo-Youn; Kim, Jae H

    2017-01-01

    Background After adrenalectomy, urinary fractionated metanephrine concentrations are expected to be reduced. However, there are few studies suggesting cut-offs for adrenalectomy patients. Methods Urinary metanephrine and normetanephrine concentrations in adrenalectomy patients and two controls were compared and hormonal concentrations were evaluated via time intervals after surgery. Results The median urinary metanephrine level after unilateral adrenalectomy was lower than that of the non-pheochromocytoma controls but comparable to healthy controls. Urinary normetanephrine concentrations did not differ between adrenalectomy patients and non-pheochromocytoma controls, although both group had levels higher than those of healthy controls. The median urinary normetanephrine level in the immediate postoperative period was higher than in the later period. Conclusions Urinary metanephrine concentrations were lower after adrenalectomy, but urinary normetanephrine concentrations were not changed compared with the non-pheochromocytoma controls. However, urinary normetanephrine concentrations in the patient group were higher than levels in the heathy controls.

  3. Cross-sectional analysis of baseline differences of candidates for rotator cuff surgery: a sex and gender perspective

    Directory of Open Access Journals (Sweden)

    Davis Aileen M

    2009-02-01

    Full Text Available Abstract Background The word "sex" refers to biological differences between men and women. Gender refers to roles, behaviors, activities, and attributes that a given society considers appropriate for men and women. Traditionally, treatment decisions have been based on patient's sex without including the gender. Assessment of disability secondary to musculoskeletal problems would not be complete or accurate unless potentially relevant biological and non-biological aspects of being a man or woman are taken into consideration. The purposes of this study were to: 1 investigate the difference in pre-operative characteristics between men and women who were candidates for rotator cuff surgery; and, 2 assess the relationship between level of disability and factors that represent sex and factors that signify gender. Method This was a cross-sectional study. The primary outcome measure of disability was a disease-specific outcome measure, the Western Ontario Rotator Cuff (WORC index, and independent variables were sex, age, hand dominance, shoulder side involvement, BMI, co-morbidity, medication use, work status, smoking habits, strength, range of motion, level of pathology, concurrent osteoarthritis, expectations for recovery, and participation restriction. Parametric, non-parametric, univariable, subgroup, and multivariable analyses were conducted. Results One hundred and seventy patients were included in the study. The mean age was 57 ± 11, 85 were females. Women reported higher levels of disability despite similar or lower levels of pathology. Scores of the WORC were strongly influenced by factors that represented "gender" such as participation restriction (F = 28.91, p Conclusion Gender-related factors such as expectations and participation limitations have an independent impact on disability in men and women undergoing rotator cuff related surgery.

  4. Can preoperative sex-related differences in hemostatic parameters predict bleeding in orthognathic surgery?

    DEFF Research Database (Denmark)

    Jared Olsen, Jesper; Ingerslev, Janne; Thorn, Jens Jørgen

    2016-01-01

    -one consecutive patients undergoing bimaxillary OS were included and subsequently grouped according to sex (26 men and 15 women). The main finding was that male patients bled twice as much as female patients on average (400 mL [interquartile range, 300 to 500 mL] vs 200 mL [interquartile range, 63 to 288 mL]; P...... adjusted for these confounders (P = .18). CONCLUSIONS: Preoperative sex-related increases in measures of fibrin turnover predict IOB volume in bimaxillary OS, with women displaying a significantly lower IOB volume than men....

  5. Arabidopsis plants grown in the field and climate chambers significantly differ in leaf morphology and photosystem components

    Directory of Open Access Journals (Sweden)

    Mishra Yogesh

    2012-01-01

    Full Text Available Abstract Background Plants exhibit phenotypic plasticity and respond to differences in environmental conditions by acclimation. We have systematically compared leaves of Arabidopsis thaliana plants grown in the field and under controlled low, normal and high light conditions in the laboratory to determine their most prominent phenotypic differences. Results Compared to plants grown under field conditions, the "indoor plants" had larger leaves, modified leaf shapes and longer petioles. Their pigment composition also significantly differed; indoor plants had reduced levels of xanthophyll pigments. In addition, Lhcb1 and Lhcb2 levels were up to three times higher in the indoor plants, but differences in the PSI antenna were much smaller, with only the low-abundance Lhca5 protein showing altered levels. Both isoforms of early-light-induced protein (ELIP were absent in the indoor plants, and they had less non-photochemical quenching (NPQ. The field-grown plants had a high capacity to perform state transitions. Plants lacking ELIPs did not have reduced growth or seed set rates, but their mortality rates were sometimes higher. NPQ levels between natural accessions grown under different conditions were not correlated. Conclusion Our results indicate that comparative analysis of field-grown plants with those grown under artificial conditions is important for a full understanding of plant plasticity and adaptation.

  6. Reconstructive pelvic surgery and plastic surgery: safety and efficacy of combined surgery.

    Science.gov (United States)

    Craig, Jocelyn B; Noblett, Karen L; Conner, Caroline A; Budd, Michael; Lane, Felicia L

    2008-12-01

    The purpose of this study was to address the safety of combining aesthetic and pelvic floor reconstructive procedures. Fifty-four subjects were included in a case-control study; 18 patients undergoing combined pelvic and plastic reconstructive surgery, age and procedure matched to 18 pelvic surgery and 18 plastic surgery only controls. Chi-square, t test, and Kruskal-Wallis analysis were used to compare the estimated blood loss (EBL), body mass index (BMI), hospital days, operative times, and complications between the groups. No differences were seen with regards to age, BMI, or EBL. There was, however, a significant increase in minor complications and hospital stay after combined procedures relative to the pelvic surgery control group but not the aesthetic control group. Operative times were only greater during combined procedures relative to isolated pelvic floor procedures. Combining pelvic and aesthetic procedures may increase complications, operative times, and length of hospital stay when compared to pelvic reconstructive surgery alone.

  7. Orthognathic surgery with or without induced hypotension.

    Science.gov (United States)

    Carlos, E; Monnazzi, M S; Castiglia, Y M M; Gabrielli, M F R; Passeri, L A; Guimarães, N C

    2014-05-01

    This study involved a retrospective evaluation of patients subjected to surgery for dentofacial deformities treated without induced controlled hypotension (group I, n=50) and a prospective evaluation of patients who were subjected to surgery under hypotensive general anaesthesia (group II, n=50). No statistical differences were found between the study groups with regard to the duration of surgery. However, there were statistically significant differences in the need for blood transfusion and the occurrence of bradycardia during the maxillary down-fracture. Hypotensive anaesthesia decreased the need for a blood transfusion and the occurrence of bradycardia, and is therefore considered highly beneficial for patients undergoing orthognathic surgery.

  8. Commonly used bowel preparations have significant and different effects upon cell proliferation in the colon: a pilot study

    Directory of Open Access Journals (Sweden)

    Riley Stuart A

    2008-11-01

    Full Text Available Abstract Background Markers of crypt cell proliferation are frequently employed in studies of the impact of genetic and exogenous factors on human colonic physiology. Human studies often rely on the assessment of tissue acquired at endoscopy. Modulation of cell proliferation by bowel preparation with oral laxatives may confound the findings of such studies, but there is little data on the impact of commonly used bowel preparations on markers of cell proliferation. Methods Crypt length, crypt cellularity and crypt cell proliferation were assessed in biopsies acquired after preparation with either Klean-Prep or Picolax. Crypt cell proliferation was assessed by whole-mount mitotic figure count, and by two different immunohistochemical (IHC labelling methods (Ki-67 and pHH3. Subsequent biopsies were obtained from the same patients without bowel preparation and similarly assessed. Parameters were compared between groups using analysis of variance and paired t-tests. Results There were significant differences in labelling indices (LI between biopsies taken after Klean-prep and those taken after Picolax preparation, for both Ki67 (p = 0.019 and pHH3 (p = 0.017. A similar trend was seen for whole-mount mitotic figure counts. Suppression or elevation of proliferation parameters by bowel preparation may mask any effect due to an intervention or disease. Conclusion Commonly used bowel preparations may have significant and different effects on crypt cell proliferation. This should be taken into account when designing studies and when considering the findings of existing studies.

  9. [Aesthetic surgery].

    Science.gov (United States)

    Bruck, Johannes C

    2006-01-01

    The WHO describes health as physical, mental and social well being. Ever since the establishment of plastic surgery aesthetic surgery has been an integral part of this medical specialty. It aims at reconstructing subjective well-being by employing plastic surgical procedures as described in the educational code and regulations for specialists of plastic surgery. This code confirms that plastic surgery comprises cosmetic procedures for the entire body that have to be applied in respect of psychological exploration and selection criteria. A wide variety of opinions resulting from very different motivations shows how difficult it is to differentiate aesthetic surgery as a therapeutic procedure from beauty surgery as a primarily economic service. Jurisdiction, guidelines for professional conduct and ethical codes have tried to solve this question. Regardless of the intention and ability of the health insurances, it has currently been established that the moral and legal evaluation of advertisements for medical procedures depends on their purpose: advertising with the intent of luring patients into cosmetic procedures that do not aim to reconstruct a subjective physical disorder does not comply with a medical indication. If, however, the initiative originates with the patient requesting the amelioration of a subjective disorder of his body, a medical indication can be assumed.

  10. Comparative evaluation of different methods of surgery in patients with benign prostatic hyperplasia large

    Directory of Open Access Journals (Sweden)

    Z. A. Kadyrov

    2014-11-01

    Full Text Available This paper presents the results of different removal methods of the prostate in 122 patients with benign prostatic hyperplasia in larger sizes (80 ml. The perioperations data of extraperitoneoscopic, traditional simple prostatectomy (EP, TTP and RP and TUR were analyzed. The results of blood loss, time of activation, the uses of analgesics, time of irrigation, Hb dinamic, duration of catheterization and hospital stay after the TP were worse compared to other methods. EP has long operation time however short time duration of catheterization and hospital stay, and the minimal use of analgesics make this method more feasible. TUR and RP demonstrate better results in many parameters. It was revealed that early and late postoperative complications were more common in patients after TUR – 93.2 % and traditional prostatectomy (TTP – 65 %, compared to the RP and EP – 20.5 % and 41.9 %, respectively.

  11. Comparative evaluation of different methods of surgery in patients with benign prostatic hyperplasia large

    Directory of Open Access Journals (Sweden)

    Z. A. Kadyrov

    2013-01-01

    Full Text Available This paper presents the results of different removal methods of the prostate in 122 patients with benign prostatic hyperplasia in larger sizes (80 ml. The perioperations data of extraperitoneoscopic, traditional simple prostatectomy (EP, TTP and RP and TUR were analyzed. The results of blood loss, time of activation, the uses of analgesics, time of irrigation, Hb dinamic, duration of catheterization and hospital stay after the TP were worse compared to other methods. EP has long operation time however short time duration of catheterization and hospital stay, and the minimal use of analgesics make this method more feasible. TUR and RP demonstrate better results in many parameters. It was revealed that early and late postoperative complications were more common in patients after TUR – 93.2 % and traditional prostatectomy (TTP – 65 %, compared to the RP and EP – 20.5 % and 41.9 %, respectively.

  12. Fourier transform infrared microspectroscopy shows significant differences between spectra of undifferentiated and polynucleated FLG 29.1 dried cells

    Science.gov (United States)

    Romano, Salvatore; Benvenuti, Susanna; Conti, Antonio; Benedetti, Enzo; Bramanti, Emilia; Rossi, Ilaria; Benedetti, Edoardo

    1994-02-01

    In a recent study made on cultures of human leukaemic cells (FLG 29.1 cell line) we were able to detect, by IR microspectroscopy, some significant IR spectroscopic variations following differentiation of cells towards osteoclastic-like behavior. The present study was undertaken on the same cell line in order to monitor biochemical structure variations following fusion induced by polyetilenglycole (PEG), using FTIR microspectroscopy. The finger-print region of all the spectra was retained and normalized according to a new regression procedure. Eleven bands were selected and total band power and mean power per unit frequency were compared with the corresponding reference session bands by a Dunnett's T test. Significant differences were found in both the tested variables only between treated and untreated cells, in 6 bands.

  13. The circadian variation in Anti-Mullerian hormone in patients with polycystic ovary syndrome differs significantly from normally ovulating women.

    Directory of Open Access Journals (Sweden)

    Leif Bungum

    Full Text Available OBJECTIVE: [corrected] To improve the biologic understanding of the Polycystic Ovarian Syndrome (PCOS condition by examining the circadian variation and relationship between Anti Müllerian Hormone (AMH, gonadotropins and ovarian steroids in PCOS patients compared to normally ovulating and menstruating women. By comparing the pattern of co-variation between AMH and Luteinizing Hormone, two compounds closely linked to hyperandrogenism and anovulation in PCOS, the involvement of the Hypothalamic-Pituitary-Ovarian axis in PCOS pathology could be elucidated. PATIENTS: Eight normal-weighted young, anovulatory PCOS-women as study group and ten normal menstruating and ovulating women as controls. INTERVENTIONS: Observational prospective study of the circadian variation in AMH, gonadotropins, sex steroids and androgens in a study and a control group. A circadian profile was performed in each study and control subject during a 24-h period by blood sampling every second hour, starting at 8:00 a.m. and continuing until 8:00 a.m. the following day. RESULTS: Significant differences in hormonal levels were found between the groups, with higher concentrations of AMH, LH and androgens in the PCOS group and lower amounts of FSH and progesterone. A distinct difference in the circadian variation pattern of AMH and LH between PCOS patients and normal controls was seen, with PCOS patients presenting a uniform pattern in serum levels of AMH and LH throughout the study period, without significant nadir late-night values as was seen in the control group. In PCOS women, a significant positive association between LH/ FSH and testosterone was found opposite to controls. MAIN OUTCOME MEASURES: Circadian variation in Anti-Müllerian Hormone, gonadotropins and ovarian steroids and the covariation between them. CONCLUSION: A significant difference in the circadian secretion of LH and AMH in PCOS women compared to normally ovulating women indicate an increased GnRH pulse

  14. Pre- and/or Intra-Operative Prescription of Diuretics, but Not Renin-Angiotensin-System Inhibitors, Is Significantly Associated with Acute Kidney Injury after Non-Cardiac Surgery: A Retrospective Cohort Study.

    Science.gov (United States)

    Tagawa, Miho; Ogata, Ai; Hamano, Takayuki

    2015-01-01

    Pre- and/or intra-operative use of diuretics, angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin II receptor blockers (ARB) constitutes a potentially modifiable risk factor for postoperative acute kidney injury (AKI). It has been studied whether use of these drugs predicts AKI after cardiac surgery. The objective of this study was to examine whether administration of these agents was independently associated with AKI after non-cardiac surgery. This was a retrospective observational study. Inclusion criteria were adult patients (age ≥ 18) who underwent non-cardiac surgery under general anesthesia from 2007 to 2009 at Kyoto Katsura Hospital. Exclusion criteria were urological surgery, missing creatinine values, and preoperative dialysis. The exposures of interest were pre- and/or intra-operative use of diuretics or ACE-I/ARB. Outcome variables were postoperative AKI as defined by the AKI Network (increase in creatinine ≥ 0.3 mg/dL or 150% within 48 hours, or urine output 6 hours). Multivariable logistic regression analyses were conducted and adjusted for potential confounders. Propensity scores (PS) for receiving diuretics or ACE-I/ARB therapy were estimated and PS adjustment, PS matching, and inverse probability weighting were performed. There were 137 AKI cases (5.0%) among 2,725 subjects. After statistical adjustment for patient and surgical characteristics, odds (95% CI) of postoperative AKI were 2.07 (1.10-3.89) (p = 0.02) and 0.89 (0.56-1.42) (p = 0.63) in users of diuretics and ACE-I/ARB, respectively, compared with non-users. PS adjustment, PS matching, and inverse probability weighting yielded similar results. The effect size of diuretics was significantly greater in the patients with lower propensity for diuretic use (p for interaction cardiac surgery, especially in patients with low propensity for diuretic use. It might be reasonable to withhold preoperative diuretics in these patients.

  15. The Impact of Two Different Transfusion Strategies on Patient Immune Response during Major Abdominal Surgery: A Preliminary Report

    Directory of Open Access Journals (Sweden)

    Kassiani Theodoraki

    2014-01-01

    Full Text Available Blood transfusion is associated with well-known risks. We investigated the difference between a restrictive versus a liberal transfusion strategy on the immune response, as expressed by the production of inflammatory mediators, in patients subjected to major abdominal surgery procedures. Fifty-eight patients undergoing major abdominal surgery were randomized preoperatively to either a restrictive transfusion protocol or a liberal transfusion protocol (with transfusion if hemoglobin dropped below 7.7 g dL−1 or 9.9 g dL−1, respectively. In a subgroup of 20 patients randomly selected from the original allocation groups, blood was sampled for measurement of IL-6, IL-10, and TNFα. Postoperative levels of IL-10 were higher in the liberal transfusion group on the first postoperative day (49.82±29.07 vs. 15.83±13.22 pg mL−1, P<0.05. Peak postoperative IL-10 levels correlated with the units of blood transfused as well as the mean duration of storage and the storage time of the oldest unit transfused (r2=0.38, P=0.032, r2=0.52, P=0.007, and r2=0.68, P<0.001, respectively. IL-10 levels were elevated in patients with a more liberal red blood cell transfusion strategy. The strength of the association between anti-inflammatory IL-10 and transfusion variables indicates that IL-10 may be an important factor in transfusion-associated immunomodulation. This trial is registered under ClinicalTrials.gov Identifier: NCT02020525.

  16. Lack of significant differences in immunity against diphtheria between populations of Eastern and Western regions of Poland.

    Science.gov (United States)

    Chudnicka, Alina; Walory, Jarosław

    2003-01-01

    Incidents of diphtheria in countries which were formerly part of the Soviet Union (Ukraine, Russia and Belorus) resulted in the need to evaluate thoroughly the effectiveness of preventive vaccination in Poland, especially in the border regions of the country where the biggest migration of population can be observed. The aim of this work was a comparison of the immunity to diphtheria in two geographically different regions of Poland--eastern (Lublin) and western (Zielona Gora) ones. It showed immunoprophylaxis to diphtheria that was implemented on these areas. Diphtheria antitoxin level (IgG) was determined with application of the ELISA method in 1236 (529/707) people. No significant differences were found in the level of antibodies in the groups 19 years of age in people below the protective titre (0.1 IU/ml). The difference occurring in the interval between 2nd and 18th year of life (in western Poland 7.6% and in eastern Poland 16%) may result from different implementation of the vaccination program in these regions (booster doses). Recommendations for vaccination to diphtheria in people over 25 years of age should be implemented especially in the frontier regions of Poland adjoining countries threatened with diphtheria occurrence.

  17. Pharmacokinetics and pharmacodynamics of propofol in children undergoing different types of surgeries.

    Science.gov (United States)

    Bartkowska-Śniatkowska, Alicja; Bienert, Agnieszka; Wiczling, Paweł; Owczarek, Marcin; Rosada-Kurasińska, Jowita; Grześkowiak, Małgorzata; Matysiak, Jan; Kokot, Zenon J; Kaliszan, Roman; Grześkowiak, Edmund

    2014-10-01

    Propofol is a commonly used agent in total intravenous anesthesia (TIVA). However, the link between its pharmacokinetics and pharmacodynamics has not been fully characterized in children yet. Our aim was to determine the quantitative relationship between the venous plasma concentration and bispectral index (BIS) effect in a heterogeneous group of pediatric patients undergoing various surgical procedures (ASA status I-III). Nine male and nine female patients were anesthetized with propofol-fentanyl TIVA. Sparse venous samples for propofol concentrations assay and dense BIS measurements were collected during and after the end of infusion. Nonlinear mixed-effect modeling in NONMEM was used for data analysis. A three-compartment model was linked with a classical Emax model through a biophase compartment to describe the available data. All clearance and volume terms were allometrically scaled to account for the body mass difference among the patients under study. A typical patient had their PK parameters observed within the range of literature values for children. The pharmacodynamic parameters were highly variable. The EC50 of 2.80 mg/L and the biophase distribution rate constant of 3.33 min(-1) were found for a typical patient. The BIS values in children are highly correlated with the propofol effect compartment concentrations according to the classical Emax concentration-response relationship. Children had slightly lower sensitivity to propofol and slightly higher clearance, as compared with the adult data available in literature. The intra-patient variations in the BIS require the anesthesiologist's attention in using BIS values alone to evaluate the depth of anesthesia in children. Copyright © 2014 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  18. The effectiveness of two different laparoscopic surgeries for apical support of pelvic organ prolapse.

    Science.gov (United States)

    Li, Shunshuang; Ji, Mei; Zhao, Zhao

    2015-05-01

    To evaluate the efficacy of laparoscopic colpo-uterine butterfly suspension and compare it to laparoscopic sacrocervicopexy for apical support in sexually active patients of pelvic organ prolapse. Twenty-there women with symptomatic prolapse of apical prolapse underwent laparoscopic colpo-uterine butterfly suspension and forty-five underwent laparoscopic sacrocervicopexy at the first affiliated of Zhengzhou University between January 2010 and June 2013. They all presented with at least a stage 2 apical prolapse. Pre- and post-operative data referring to pelvic organ prolapse quantification (POP-Q) system were compared. At the same time, validated questionnaire of the Pelvic Floor Distress Inventory (PFDI-20), the Pelvic Floor Impact Questionnaire (PFIQ-7) and the Pelvic organ prolapse urinary Incontinence Sexual Questionnaire (PISQ-12) were included. From 2010 to 2013, 68 patients were included. Only 3 cases lost the follow-up in the Laparoscopic sacrocervicopexy. In the laparoscopic colpo-uterine butterfly suspension, there was no recurrence versus in five the laparoscopic sacrocervicopexy. When considered the operating time and blood loss, the laparoscopic colpo-uterine butterfly suspension was more favorable. Erosion was higher in the laparoscopic sacrocervicopexy compared to the other group (0% vs 21.4%). There was no difference in the postoperative PFDI-20 score (P=0.3079), and PFIQ-7 score (P=0.8889) between the two groups, while the PISQ-12 score was much higher in the laparoscopic colpo-uterine butterfly suspension than the other group (P=0.0076). Laparoscopic colpo-uterine butterfly suspension is a more effective option for sexually active women with pelvic organ prolapse. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. Accuracy of Cardiac Output by Nine Different Pulse Contour Algorithms in Cardiac Surgery Patients: A Comparison with Transpulmonary Thermodilution

    Science.gov (United States)

    Bein, Berthold; Gruenewald, Matthias; Masing, Sarah; Huenges, Katharina; Haneya, Assad; Steinfath, Markus; Renner, Jochen

    2016-01-01

    Objective. Today, there exist several different pulse contour algorithms for calculation of cardiac output (CO). The aim of the present study was to compare the accuracy of nine different pulse contour algorithms with transpulmonary thermodilution before and after cardiopulmonary bypass (CPB). Methods. Thirty patients scheduled for elective coronary surgery were studied before and after CPB. A passive leg raising maneuver was also performed. Measurements included CO obtained by transpulmonary thermodilution (COTPTD) and by nine pulse contour algorithms (COX1–9). Calibration of pulse contour algorithms was performed by esophageal Doppler ultrasound after induction of anesthesia and 15 min after CPB. Correlations, Bland-Altman analysis, four-quadrant, and polar analysis were also calculated. Results. There was only a poor correlation between COTPTD and COX1–9 during passive leg raising and in the period before and after CPB. Percentage error exceeded the required 30% limit. Four-quadrant and polar analysis revealed poor trending ability for most algorithms before and after CPB. The Liljestrand-Zander algorithm revealed the best reliability. Conclusions. Estimation of CO by nine different pulse contour algorithms revealed poor accuracy compared with transpulmonary thermodilution. Furthermore, the less-invasive algorithms showed an insufficient capability for trending hemodynamic changes before and after CPB. The Liljestrand-Zander algorithm demonstrated the highest reliability. This trial is registered with NCT02438228 (ClinicalTrials.gov).

  20. Comparison of Post Extubation Complications in 3 Different States of Filling Endotracheal Tube Cuff with Lidocaine 4% in Elective Surgery Patients

    Directory of Open Access Journals (Sweden)

    M Moattari

    2006-10-01

    Full Text Available ABSTRACT: Introduction & Objective: Endotracheal intubation during general anesthesia is necessary to control the ventilation of patients during surgery. Nevertheless, the endotracheal tube as an external object can stimulate the patient’s airway during the emergence from general anesthesia and create different reactions and complications. To prevent these reactions, a wide variety of interventions have been examined. In this study, post-extubation endotracheal tube complications are investigated in 3 different states of lidocaine 4% for filling endotracheal tube cuffs. Materials & Methods: In this quasi-experimental clinical trial study executed in one of Shiraz hospitals during 2005-2006, 200 candidates of elective surgery being in class1 and 2 ASA were randomly divided into 4 groups (N=50. The endotracheal tube cuffs of each group members were filled with (5-10ml distilled water, lidocaine 4%, alkalized lidocaine 4% and warmed alkalized lidocaine 4%, respectively. The patients were observed for complications such as cough (for 6 hrs, sore throat, hoarseness (for 24 hrs and laryngospasm (immediately after extubation. The data were analyzed by chi square and logistic regression using SPSS. Results: The findings revealed that the frequency of cough, sore throat and hoarseness was more in the control (distilled water group as compared to the 2 groups of the study (alkalized lidocaine 4% and warmed alkalized lidocaine 4%. Distilled water and lidocaine 4% groups differed significantly in only the frequency of sore throat. The odds ratio of cough, sore throat and hoarseness was just significant for the distilled water group in comparison to warmed alkalized lidocaine 4 %. Furthermore the odds ratio of the above-mentioned complications was significant for the distilled water and lidocaine 4% groups in comparison to the warmed alkalized lidocaine 4% group. Among all the considered variables, the duration of tube existence in trachea was

  1. Significance of survivin (BIRC5 as a biomarker for the assessmet of preoperative cardiovascular risk in non-cardiac surgeries: Survivin (BIRC5 as a novel cardiac biomarker

    Directory of Open Access Journals (Sweden)

    Marković Danica

    2016-01-01

    Full Text Available Introduction: Survivin (BIRC5 is a member of the inhibitor of apoptosis family of proteins and has a very important role in the so-called 'point of no return' of cell apoptosis. The role of survivin in the development of tumors and autoimmune diseases has already been proven, however, there are increasing evidence that it is also sensitive to the existence of previous ischemic heart disease. Methods: This prospective pilot study included 78 patients who were preparing for one of the major non-cardiac surgeries. Blood was sampled within 7 preoperative days, serum was separated and frozen at -70°C. The level of survivin in serum was measured using the ELISA (Enzyme-linked immunosorbent assay method, and the results were read on DIAREADER Elx800G. Results: Patients of an average age of 71.46 ± 6.87 years had the median level of survivin 4.56 (0.00-76.78 pg/ml. Survivin has proven to be an excellent predictor of postoperative mortality (P0.05, ROC/AUC=0.782; P<0.05, ROC/ AUC=0.825;. After exclusion of extremely high values, the results in both groups were respectively: P<0.001, ROC/AUC=0.831; P<0.05, ROC/AUC=0.825. Conclusion: Survivin is a potential cardiac biomarker and itsspecificity and sensitivity has been demonstrated even in the group of patients who were not suffering from any kind of tumor.

  2. ama1 genes of sympatric Plasmodium vivax and P. falciparum from Venezuela differ significantly in genetic diversity and recombination frequency.

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    Rosalynn L Ord

    Full Text Available BACKGROUND: We present the first population genetic analysis of homologous loci from two sympatric human malaria parasite populations sharing the same human hosts, using full-length sequences of ama1 genes from Plasmodium vivax and P. falciparum collected in the Venezuelan Amazon. METHODOLOGY/PRINCIPAL FINDINGS: Significant differences between the two species were found in genetic diversity at the ama1 locus, with 18 distinct haplotypes identified among the 73 Pvama1 sequences obtained, compared to 6 unique haplotypes from 30 Pfama1 sequences, giving overall diversity estimates of h = 0.9091, and h = 0.538 respectively. Levels of recombination were also found to differ between the species, with P. falciparum exhibiting very little recombination across the 1.77 kb sequence. In contrast, analysis of patterns of nucleotide substitutions provided evidence that polymorphisms in the ama1 gene of both species are maintained by balancing selection, particularly in domain I. The two distinct population structures observed are unlikely to result from different selective forces acting upon the two species, which share both human and mosquito hosts in this setting. Rather, the highly structured P. falciparum population appears to be the result of a population bottleneck, while the much less structured P. vivax population is likely to be derived from an ancient pool of diversity, as reflected in a larger estimate of effective population size for this species. Greatly reduced mosquito transmission in 1997, due to low rainfall prior to the second survey, was associated with far fewer P. falciparum infections, but an increase in P. vivax infections, probably due to hypnozoite activation. CONCLUSIONS/SIGNIFICANCE: The relevance of these findings to putative competitive interactions between these two important human pathogen species is discussed. These results highlight the need for future control interventions to employ strategies targeting each of the parasite

  3. Analyzing Relationship Between Monoclonal Gammopathy of Undetermined Significance (MGUS) with Different Types of Neuropathy: An Observational Study.

    Science.gov (United States)

    Nabi, Shahzaib; Kahlon, Pushpinderdeep; Bozorgnia, Farshid; Arshad, Adeel; Saleem, Akmam; Kuriakose, Philip

    2016-06-01

    To analyze multiple variables, including immunoglobulin subtypes in patients with monoclonal gammopathy of undetermined significance (MGUS) and different types of neuropathy. This was a retrospective, single center study done in a tertiary care hospital in the United States. The data was collected for years 2001-2011. Inclusion criteria were the presence of MGUS and neuropathy. Exclusion criteria were the presence of other factors such as diabetes, vitamin B12 deficiency, alcoholism etc. which can cause neuropathy. Patients with IgM MGUS were compared with patients having Non-IgM MGUS. A total of 281 patients were analyzed in this study. The average age at the time of diagnosis of MGUS and neuropathy was 68 years. The most common type of neuropathy was sensorimotor peripheral neuropathy (46 %). The most common location of neuropathy was the lower extremities (68 %). Among our patients, 52 % had their neuropathy symptoms for 1-5 years before presenting to the clinic. When IgM MGUS was compared with Non-IgM MGUS, a statistically significant difference was found in terms of race (White vs. Others, OR 4.43, 95 % CI 2.13, 9.19, p < 0.001) and survival status (OR 1.98, 95 % CI 1.01, 3.90, p = 0.046). Patients with MGUS are prone to develop different types of neuropathies. Caucasians are more likely to have IgM MGUS as compared to other races. IgM MGUS is generally related to worse outcomes as compared to Non-IgM MGUS. Medical therapies, including gabapentin and pregabalin are effective treatments and the response rate can be as high as 80-90 % with these medications.

  4. THE PROGNOSIS SIGNIFICANCE OF CATHEPSIN-D EXPRESSION IN THE DIFFERENT LOCATIONS IN AXILLARY NODES NEGATIVE CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: The aim of this study was to investigate Cathepsin-D (Cath-D) expression in different location and its relationship with prognosis in the axillary lymph nodes negative (ANN) breast cancer patients. Methods: Cath-D expression in 192 cases of breast carcinoma were examined by immunohistochemistry. Depending on different parts of expression, three evaluating methods were used, compared and analysed. Results: The positive rate of Cath-D expression in ANN breast cancer with poor prognosis group and axillary nodes positive (ANP) group were significantly higher than that in ANN breast cancer with good prognosis group (x2=23.20, P0.05). Cath-D expression in stromal cells had no statistical difference among the three groups (x2=1.56, P>0.05). When the Cath-D expression in cancer and stromal cells were counted into the positive rate, it was near the same (u1=0.47, u2=1.41, P>0.05). Conclusion: These results suggest that Cath-D expression is one of the powerful prognostic markers in ANN breast cancer. It's a reliable, practical, and convenient method to observe and evaluate Cath-D expression in cancer cells.

  5. [Minimally invasive surgery and robotic surgery: surgery 4.0?].

    Science.gov (United States)

    Feußner, H; Wilhelm, D

    2016-03-01

    Surgery can only maintain its role in a highly competitive environment if results are continuously improved, accompanied by further reduction of the interventional trauma for patients and with justifiable costs. Significant impulse to achieve this goal was expected from minimally invasive surgery and, in particular, robotic surgery; however, a real breakthrough has not yet been achieved. Accordingly, the new strategic approach of cognitive surgery is required to optimize the provision of surgical treatment. A full scale integration of all modules utilized in the operating room (OR) into a comprehensive network and the development of systems with technical cognition are needed to upgrade the current technical environment passively controlled by the surgeon into an active collaborative support system (surgery 4.0). Only then can the true potential of minimally invasive surgery and robotic surgery be exploited.

  6. Significant geomagnetic differences in both phase and amplitude observed at "conjugate" polar latitudes near the December 1903 Solstice

    Science.gov (United States)

    Egeland, Alv; Deehr, Charles

    2014-05-01

    During Roald Amundsen's exploration of the Northwest Passage (1903-1906) he conducted systematic measurements of diurnal and seasonal variations of the north magnetic dip pole (NMDP) at Gjøahavn (~ 68 N, 95 E). The NMDP variations have been largely interpreted as indicating control by the polarity of the interplanetary magnetic field (IMF); the Svalgard-Mansurov (S-M) effect. In Sir Robert Scott's Discovery expedition, geomagnetic observations were made in 1903 from Cape Armitage, Antarctica (~78 S, 168 E). Unwittingly, the measurements of Amundsen and Scott were acquired near conjugate ends of the same magnetic field lines. While their separation in solar local time is ~ 5 hours, they differ in magnetic local time less than 1/2 hour. However, up to this time no direct comparison of the two sets of magnetic observations has ever been made. This presentation contains an analysis of magnetic perturbations observed at both locations for comparison with contemporary and present day monthly-averaged diurnal variations, even if the overlap in data among these expeditions is somewhat limited. The near magnetic conjugacy of Gjøahavn- Cape Armitage locations makes these measurements valuable. Our analysis shows: (1) While similar variations appeared at both ends of the joining magnetic field they manifest significant differences in both phase and amplitude, (2) present day NMDP variations appear consistent with the S-M effect analyses when compared with satellite measurements of solar wind/IMF measurements, (3) differences at the "conjugate" locations cannot be explained in terms of the S-M effect alone. The roles of lobe cell and ionospheric conductance at polar magnetically "conjugate" locations are used to explain the observed phase and amplitude differences.

  7. Weight Loss Surgery

    Science.gov (United States)

    Weight loss surgery helps people with extreme obesity to lose weight. It may be an option if you ... caused by obesity. There are different types of weight loss surgery. They often limit the amount of food ...

  8. Do the levels of selected metals differ significantly between the roots of carious and non-carious teeth?

    Energy Technology Data Exchange (ETDEWEB)

    Malara, Piotr [Silesian Medical University, Department of Maxillofacial Surgery 20/24 Francuska Street, 40-027 Katowice (Poland)]. E-mail: malara@netinfo.pl; Kwapulinski, Jerzy [Silesian Medical University, Department of Toxicology 4 Jagiellonska Street, 41-200 Sosnowiec (Poland); Malara, Beata [Silesian Medical University, Department of Environmental Medicine and Epidemiology 19 Jordana Street, 41-808 Zabrze (Poland)

    2006-10-01

    Since the metals deposited in teeth during formation and mineralization processes are to a large extent retained, human teeth receive a considerable attention as the indicators of the heavy metal exposure. The use of permanent teeth is limited because the extraction of healthy permanent teeth just for this purpose is hardly acceptable. As the issue of the loss of elements from a carious lesion in the coronal part of a tooth remains controversial, the valuable material could only be the root of carious and fractured permanent teeth. However, to ensure the validity of the results, it should be ascertained that the levels of certain toxic and essential elements do not differ significantly between the roots of non-carious and carious teeth, and therefore this is the aim of this project. The levels of cadmium, chromium, copper, iron, manganese, lead, zinc, potassium, sodium, calcium and magnesium were determined in the roots of 344 permanent teeth (189 carious and 155 caries-free teeth) from the residents of Ruda Slaska, Poland, aged 18 to 34. No statistically significant difference between the concentration of these metals in the roots of non-carious and carious teeth was found. This finding applies to both the general population and after the grouping by donor's gender and tooth type. The concentration of lead, iron, calcium and manganese in the roots of non-carious and carious teeth exhibited dependence upon tooth type, as well as the concentration of potassium in the roots of carious teeth. Since the mineral composition of the roots of permanent teeth is similar for the non-carious, as well as the carious teeth, they can be indiscriminately selected for the tests required by a research project, as they will produce the comparable results. However, in the case of lead, iron, calcium, potassium and manganese, the comparison should be made after grouping by tooth type.

  9. Quantitative superresolution microscopy reveals differences in nuclear DNA organization of multiple myeloma and monoclonal gammopathy of undetermined significance.

    Science.gov (United States)

    Sathitruangsak, Chirawadee; Righolt, Christiaan H; Klewes, Ludger; Tammur, Pille; Ilus, Tiiu; Tamm, Anu; Punab, Mari; Olujohungbe, Adebayo; Mai, Sabine

    2015-05-01

    The mammalian nucleus has a distinct substructure that cannot be visualized directly by conventional microscopy. In this study, the organization of the DNA within the nucleus of multiple myeloma (MM) cells, their precursor cells (monoclonal gammopathy of undetermined significance; MGUS) and control lymphocytes of the representative patients is visualized and quantified by superresolution microscopy. Three-dimensional structured illumination microscopy (3D-SIM) increases the spatial resolution beyond the limits of conventional widefield fluorescence microscopy. 3D-SIM reveals new insights into the nuclear architecture of cancer as we show for the first time that it resolves organizational differences in intranuclear DNA organization of myeloma cells in MGUS and in MM patients. In addition, we report a significant increase in nuclear submicron DNA structure and structure of the DNA-free space in myeloma nuclei compared to normal lymphocyte nuclei. Our study provides previously unknown details of the nanoscopic DNA architecture of interphase nuclei of the normal lymphocytes, MGUS and MM cells. This study opens new avenues to understanding the disease progression from MGUS to MM. © 2014 Wiley Periodicals, Inc.

  10. Quantifying Forest Spatial Pattern Trends at Multiple Extents: An Approach to Detect Significant Changes at Different Scales

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    Ludovico Frate

    2014-09-01

    Full Text Available We propose a procedure to detect significant changes in forest spatial patterns and relevant scales. Our approach consists of four sequential steps. First, based on a series of multi-temporal forest maps, a set of geographic windows of increasing extents are extracted. Second, for each extent and date, specific stochastic simulations that replicate real-world spatial pattern characteristics are run. Third, by computing pattern metrics on both simulated and real maps, their empirical distributions and confidence intervals are derived. Finally, multi-temporal scalograms are built for each metric. Based on cover maps (1954, 2011 with a resolution of 10 m we analyze forest pattern changes in a central Apennines (Italy reserve at multiple spatial extents (128, 256 and 512 pixels. We identify three types of multi-temporal scalograms, depending on pattern metric behaviors, describing different dynamics of natural reforestation process. The statistical distribution and variability of pattern metrics at multiple extents offers a new and powerful tool to detect forest variations over time. Similar procedures can (i help to identify significant changes in spatial patterns and provide the bases to relate them to landscape processes; (ii minimize the bias when comparing pattern metrics at a single extent and (iii be extended to other landscapes and scales.

  11. P53 and Murine Double Mimute 2 (MDM2) Expression Changes and Significance in Different Types of Endometrial Lesions

    Science.gov (United States)

    Jiang, Zhongyong; Xu, Wanqing; Dan, Gang; Liu, Yuan; Xiong, Jie

    2016-01-01

    Background Endometrial lesions are common in obstetrics and gynecology, including endometrial polyps, uterine adenomyosis, and malignant endometrial adenocarcinoma. Endometrial lesions seriously affect women’s health, fertility, quality of life, and life safety. As a pro-apoptosis gene, p53 is considered to be closely related with human tumors. Murine double mimute 2 (MDM2) is an oncogene that can promote tumor occurrence and development. P53 and MDM2 expression and significance in different types of endometrial lesions have not been fully elucidated. Material/Methods Normal endometrium, endometrial polyps, uterine adenomyosis, and endometrial adenocarcinoma tissue samples were collected. Real-time PCR was used to detect p53 and MDM2 mRNA expression. Immunohistochemical staining and Western blot analysis were applied to test p53 and MDM2 protein expression. Their correlation with clinical staging of endometrial adenocarcinoma was analyzed. Results P53 and MDM2 mRNA and protein expression were significantly elevated in the endometrial polyps group and the endometrial adenocarcinoma group compared with the normal control group (Pendometrial adenocarcinoma compared with endometrial polyps (P0.05). P53 and MDM2 mRNA and protein level showed a positive correlation. Significantly higher expression of p53 or MDM2 was observed in patients with stage III compared to those in patients with stage II. Higher expression was also observed in patients with stage II than in patients with stage I. Conclusions P53 and MDM2 mRNA and protein were elevated in endometrial polyps and endometrial adenocarcinoma and their expressions were correlated with clinical staging of endometrial adenocarcinoma. They can promote cancer occurrence and development, and can be treated to assist diagnosis and provide a reference for treatment. PMID:27924072

  12. The clinical significance of axillary sentinel lymph node biopsy in different clinical stages breast cancer patients after neoadjuvant chemotherapy

    Institute of Scientific and Technical Information of China (English)

    Juan Xu; Xinhong Wu; Yaojun Feng; Feng Yuan; Wei Fan

    2013-01-01

    Objective:We aimed to study the success and false negative rate of sentinel lymph node biopsy (SLNB) in dif-ferent clinical stages breast cancer patients being carried out with neoadjuvant chemotherapy (NAC), and the clinical signifi-cance of SLNB, we conducting this trial. Methods:One hunderd and thirty-seven cases were enrol ed in this clinical research from March 2003 to March 2007. Al of the patients’ sentinel lymph nodes were detected with 99mTc-Dx and methylene blue. There were 61 patients with stage T1-2N0M0 carried SLNB without NAC (group A), 76 cases were carried out NAC 3-4 cycles before SLNB, including 39 T2-4N0-1M0 cases (group B) and 27 T2-4N2-3M0 cases (group C). The success and false negative rate of SLNB were analysed with chi-square test. Results:In group A, the successful and false negative rate of SLNB were 92.31%(36/39), 8.57%(3/35), and in group B and C were 92.31%(36/39), 8.57%(3/35) and 74.07%(20/27), 18.52%(5/27), respectively. The successful rate of group C decreased and false negative rate increased significantly compared with group A and B (P0.05). Conclusion:The SLNB can accurately predict lymph node status of axil ary lymph node in N0-1 stage patients with NAC, but in N2-3 stage patients the success rate decreased and false rate increased negative significantly.

  13. The prion protein gene polymorphisms associated with bovine spongiform encephalopathy susceptibility differ significantly between cattle and buffalo.

    Science.gov (United States)

    Zhao, Hui; Du, Yanli; Chen, Shunmei; Qing, Lili; Wang, Xiaoyan; Huang, Jingfei; Wu, Dongdong; Zhang, Yaping

    2015-12-01

    Prion protein, encoded by the prion protein gene (PRNP), plays a crucial role in the pathogenesis of transmissible spongiform encephalopathies (TSEs). Several polymorphisms within the PRNP are known to be associated with influencing bovine spongiform encephalopathy (BSE) susceptibility in cattle, namely two insertion/deletion (indel) polymorphisms (a 23-bp indel in the putative promoter and a 12-bp indel in intron 1), the number of octapeptide repeats (octarepeats) present in coding sequence (CDS) and amino acid polymorphisms. The domestic buffaloes, Bubalus bubalis, are a ruminant involved in various aspects of agriculture. It is of interest to ask whether the PRNP polymorphisms differ between cattle and buffalo. In this study, we analyzed the previously reported polymorphisms associated with BSE susceptibility in Chinese buffalo breeds, and compared these polymorphisms in cattle with BSE, healthy cattle and buffalo by pooling data from the literature. Our analysis revealed three significant findings in buffalo: 1) extraordinarily low deletion allele frequencies of the 23- and 12-bp indel polymorphisms; 2) significantly low allelic frequencies of six octarepeats in CDS and 3) the presence of S4R, A16V, P54S, G108S, V123M, S154N and F257L substitutions in buffalo CDSs. Sequence alignments comparing the buffalo coding sequence to other species were analyzed using the McDonald-Kreitman test to reveal five groups (Bison bonasus, Bos indicus, Bos gaurus, Boselaphus tragocamelus, Syncerus caffer caffer) with significantly divergent non-synonymous substitutions from buffalo, suggesting potential divergence of buffalo PRNP and others. To the best of our knowledge this is the first study of PRNP polymorphisms associated with BSE susceptibility in Chinese buffalo. Our findings have provided evidence that buffaloes have a unique genetic background in the PRNP gene in comparison with cattle.

  14. Contents of chemical elements in stomach during prenatal development: different age-dependent dynamical changes and their significance

    Institute of Scientific and Technical Information of China (English)

    Shao-Fan Hou; Hai-Rong Li; Li-Zhen Wang; De-Zhu Li; Lin-Sheng Yang; Chong-Zheng Li

    2003-01-01

    AIM: To observe dynamic of different chemical elements in stomach tissue during fetal development.METHODS: To determine contents of the 21 chemical elements in each stomach samples from fetus aging four to ten months. The content values were compared to those from adult tissue samples, and the values for each month group were also analyzed for dynamic changes.RESULTS: Three representations were found regarding the relationship between contents of the elements and ages of the fetus, including the positive correlative (K), reversely correlative (Na, Ca, P, Al, Cu, Zn, Fe, Mn, Cr, Sr, Li, Cd, Ba,Se ) and irrelevant groups (Mg, Co, Ni, V, Pb, Ti).CONCLUSION: The chemical elements' contents in stomach tissues were found to change dynamically with the stomach weights. The age-dependent representations for different chemical elements during the prenatal development may be of some significance for assessing development of fetal stomach and some chemical elements. The data may be helpful for the nutritional balance of fetus and mothers during prenatal development and even the perinatal stages.

  15. Judgments of learning are significantly higher following feedback on relatively good versus relatively poor trials despite no actual learning differences.

    Science.gov (United States)

    Carter, Michael J; Smith, Victoria; Ste-Marie, Diane M

    2016-02-01

    Studies have consistently shown that prospective metacognitive judgments of learning are often inaccurate because humans mistakenly interpret current performance levels as valid indices of learning. These metacognitive discrepancies are strongly related to conditions of practice. Here, we examined how the type of feedback (after good versus poor trials) received during practice and awareness (aware versus unaware) of this manipulation affected judgments of learning and actual learning. After each six-trial block, participants received feedback on their three best trials or three worst trials and half of the participants were made explicitly aware of the type of feedback they received while the other half were unaware. Judgments of learning were made at the end of each six-trial block and before the 24-h retention test. Results indicated no motor performance differences between groups in practice or retention; however, receiving feedback on relatively good compared to relatively poor trials resulted in significantly higher judgments of learning in practice and retention, irrespective of awareness. These results suggest that KR on relatively good versus relatively poor trials can have dissociable effects on judgments of learning in the absence of actual learning differences, even when participants are made aware of their feedback manipulation.

  16. Contents of chemical elements in stomach during prenatal development: different age-dependent dynamical changes and their significance

    Science.gov (United States)

    Hou, Shao-Fan; Li, Hai-Rong; Wang, Li-Zhen; Li, De-Zhu; Yang, Lin-Sheng; Li, Chong-Zheng

    2003-01-01

    AIM: To observe dynamic of different chemical elements in stomach tissue during fetal development. METHODS: To determine contents of the 21 chemical elements in each stomach samples from fetus aging four to ten months. The content values were compared to those from adult tissue samples, and the values for each month group were also analyzed for dynamic changes. RESULTS: Three representations were found regarding the relationship between contents of the elements and ages of the fetus, including the positive correlative (K), reversely correlative (Na, Ca, P, Al, Cu, Zn, Fe, Mn, Cr, Sr, Li, Cd, Ba, Se) and irrelevant groups (Mg, Co, Ni, V, Pb, Ti). CONCLUSION: The chemical elements’ contents in stomach tissues were found to change dynamically with the stomach weights. The age-dependent representations for different chemical elements during the prenatal development may be of some significance for assessing development of fetal stomach and some chemical elements. The data may be helpful for the nutritional balance of fetus and mothers during prenatal development and even the perinatal stages. PMID:12717857

  17. Thyroid Surgery

    Science.gov (United States)

    ... Fax/Phone Home » Thyroid Surgery Leer en Español Thyroid Surgery GENERAL INFORMATION Your doctor may recommend that ... made in conjunction with your endocrinologist and surgeon. Thyroid Surgery FAQs QUESTIONS AND CONSIDERATIONS When thyroid surgery ...

  18. Plastic Surgery

    Science.gov (United States)

    ... Surgery? A Week of Healthy Breakfasts Shyness Plastic Surgery KidsHealth > For Teens > Plastic Surgery Print A A ... forehead lightened with a laser? What Is Plastic Surgery? Just because the name includes the word "plastic" ...

  19. Validation of four different risk stratification models in patients undergoing heart valve surgery in a single center in China

    Institute of Scientific and Technical Information of China (English)

    ZHANG Chun-xiao; XU Jian-ping; GE Yi-peng; WEI Yu; YANG Yan; LIU Feng; SHI Yi

    2011-01-01

    Background Several risk stratification models have been developed for cardiac surgery. This study aimed to evaluate the accuracy of four existing risk stratification models, the Fuwai System for Cardiac Operative Risk Evaluation (FuwaiSCORE), the Society of Thoracic Surgeons 2008 cardiac surgery risk model for isolated valve surgery (the STS model), the European System for Cardiac Operative Risk Evaluation (EuroSCORE) and the initial Parsonnet's score (the Parsonnet model) in predicting prolonged intensive care unit (ICU) stay in Chinese patients undergoing heart valve surgery. Methods Data were collected retrospectively from records of 1333 consecutive patients who received heart valve surgery in a single center between November 2006 and December 2007. Prolonged ICU stay was defined as not less than 124 hours. Calibration was assessed using the Hosmer-Lemeshow (H-L) goodness of fit test. Discrimination was assessed using the receiver-operating-characteristic (ROC) curve area. Results The FuwaiSCORE showed good calibration and discrimination compared with other risk models. According to the H-L statistics, the value of the FuwaiSCORE was 12.82, P>0.1. The area under ROC curve of the FuwaiSCORE was 0.81 (95%C/0.78-0.84). Conclusions Our study suggests that the FuwaiSCORE is superior to the other three risk models in predicting prolonged length of ICU stay in Chinese patients with heart valve surgery. Having fewer variables, the system is much easier for bedside use than other systems.

  20. Religious Freedom and Equality as Celebration of Difference: A Significant Development in Recent South African Constitutional Case-Law

    Directory of Open Access Journals (Sweden)

    L du Plessis

    2009-12-01

    Full Text Available This contribution focuses on the way in which the South African Constitutional Court has, since 1997, been dealing with the (seemingly eccentric claims of (assumedly idiosyncratic 'religious Others'. Developments in this regard have, for the time being at least, culminated in the Constitutional Court's landmark judgment in MEC for Education: KwaZulu Natal v Pillay 2008 (2 BCLR 99 (CC, 2008 (1 SA 474 (CC (hereafter Pillay. Constitutional Court judgments since 1997 manifesting the adjudication of such unconventional claims are assessed, eventually getting to Pillay as benchmark. This remarkable judgment, dealing with a deceptively mundane issue, has played a considerable role in fleshing out a jurisprudence of difference, putting an adherent of a vulnerable, minority religion in the right. This is not just a high point in the adjudication of constitutional entitlements of the religious (and cultural Other in South Africa, but also a significant contribution to the growth of a jurisprudence sensitive to the predicaments and constitutional entitlements of unconventional, 'non-mainstream' claimants of religious (and cultural rights. Finally Pillay illustrates that the constitutional guarantee of the right to freedom of religion, conscience, belief and opinion (entrenched in section 15(1 of the Constitution of Republic of South Africa 1996 can be crucially dependent upon due effect being given to the proscription of unfair discrimination on the grounds of religion, conscience, belief and opinion elsewhere (namely in section 9(3 of the Constitution.

  1. Analysis of protein composition of rabbit aqueous humor following two different cataract surgery incision procedures using 2-DE and LC-MS/MS

    Directory of Open Access Journals (Sweden)

    McDonnell Peter J

    2011-02-01

    Full Text Available Abstract Background The aqueous humor (AH, a liquid of the anterior and posterior chamber of the eye, comprises many proteins with various roles and important biological functions. Many of these proteins have not been identified yet and their functions in AH are still unknown. Recently, our laboratory published the protein database of AH obtained from healthy rabbits which expanded known protein identifications by 65%. Our present study extends our previous work and analyses AH following two types of cataract surgery incision procedures (clear corneal and limbal incisions by using two dimensional gel electrophoresis (2-DE and liquid chromatography tandem mass spectrometry (LC-MS/MS. Although both incision protocols are commonly used during cataract surgeries, the difference in protein composition and their release into AH following each surgery has never been systematically compared and remains unclear. The first step, which is the focus of this work, is to assess the scale of the protein change, at which time does maximum release occurs and when possible, to identify protein changes. Results Samples of AH obtained prior to surgery and at different time points (0.5, 2, 12, 24 and 48 hours following surgery (n = 3/protocol underwent protein concentration determination, 2-DE and LC-MS/MS. There was a large (9.7 to 31.2 mg/mL and rapid (~0.5 hour influx of proteins into AH following either incision with a return to baseline quantities after 12 hours and 24 hours for clear corneal and limbal incision, respectively. We identified 80 non-redundant proteins, and compared to our previous study on healthy AH, 67.5% of proteins were found to be surgery-specific. In addition, 51% of those proteins have been found either in clear corneal (20% or limbal incision (31% samples. Conclusions Our results imply that a mechanism of protein release into AH after surgery is a global response to the surgery rather than increase in amount of protective proteins found

  2. Regional Differences Between US and Europe in Radiological Osteoarthritis and Self Assessed Quality of Life in Patients Undergoing Total Hip Arthroplasty Surgery

    DEFF Research Database (Denmark)

    Gromov, Kirill; Greene, Meridith E; Sillesen, Nanna H;

    2014-01-01

    Precise indications for THA remain unclear and regional differences might exist in selecting patients for surgery. In this study we investigate radiological OA grade and self-reported quality of life in 909 patients undergoing THA in 16 centers across US and Europe. Patients in US were younger an...

  3. Clinical results with two different methods of root-end preparation and filling in apical surgery: mineral trioxide aggregate and adhesive resin composite

    DEFF Research Database (Denmark)

    von Arx, Thomas; Hänni, Stefan; Jensen, Simon Storgård

    2010-01-01

    The aim of apical surgery is to hermetically seal the root canal system after root-end resection, thereby enabling periradicular healing. The objective of this nonrandomized prospective clinical study was to report results of 2 different root-end preparation and filling methods, ie, mineral triox...... trioxide aggregate (MTA) and an adhesive resin composite (Retroplast)....

  4. Pre- and/or Intra-Operative Prescription of Diuretics, but Not Renin-Angiotensin-System Inhibitors, Is Significantly Associated with Acute Kidney Injury after Non-Cardiac Surgery: A Retrospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Miho Tagawa

    Full Text Available Pre- and/or intra-operative use of diuretics, angiotensin-converting enzyme inhibitors (ACE-I or angiotensin II receptor blockers (ARB constitutes a potentially modifiable risk factor for postoperative acute kidney injury (AKI. It has been studied whether use of these drugs predicts AKI after cardiac surgery. The objective of this study was to examine whether administration of these agents was independently associated with AKI after non-cardiac surgery.This was a retrospective observational study. Inclusion criteria were adult patients (age ≥ 18 who underwent non-cardiac surgery under general anesthesia from 2007 to 2009 at Kyoto Katsura Hospital. Exclusion criteria were urological surgery, missing creatinine values, and preoperative dialysis. The exposures of interest were pre- and/or intra-operative use of diuretics or ACE-I/ARB. Outcome variables were postoperative AKI as defined by the AKI Network (increase in creatinine ≥ 0.3 mg/dL or 150% within 48 hours, or urine output 6 hours. Multivariable logistic regression analyses were conducted and adjusted for potential confounders. Propensity scores (PS for receiving diuretics or ACE-I/ARB therapy were estimated and PS adjustment, PS matching, and inverse probability weighting were performed.There were 137 AKI cases (5.0% among 2,725 subjects. After statistical adjustment for patient and surgical characteristics, odds (95% CI of postoperative AKI were 2.07 (1.10-3.89 (p = 0.02 and 0.89 (0.56-1.42 (p = 0.63 in users of diuretics and ACE-I/ARB, respectively, compared with non-users. PS adjustment, PS matching, and inverse probability weighting yielded similar results. The effect size of diuretics was significantly greater in the patients with lower propensity for diuretic use (p for interaction < 0.1.Prescription of diuretics, but not ACE-I/ARB, was independently associated with postoperative AKI after non-cardiac surgery, especially in patients with low propensity for diuretic use. It might

  5. Bariatric Surgery and Precision Nutrition

    Directory of Open Access Journals (Sweden)

    Carolina F. Nicoletti

    2017-09-01

    Full Text Available This review provides a literature overview of new findings relating nutritional genomics and bariatric surgery. It also describes the importance of nutritional genomics concepts in personalized bariatric management. It includes a discussion of the potential role bariatric surgery plays in altering the three pillars of nutritional genomics: nutrigenetics, nutrigenomics, and epigenetics. We present studies that show the effect of each patient’s genetic and epigenetic variables on the response to surgical weight loss treatment. We include investigations that demonstrate the association of single nucleotide polymorphisms with obesity phenotypes and their influence on weight loss after bariatric surgery. We also present reports on how significant weight loss induced by bariatric surgery impacts telomere length, and we discuss studies on the existence of an epigenetic signature associated with surgery outcomes and specific gene methylation profile, which may help to predict weight loss after a surgical procedure. Finally, we show articles which evidence that bariatric surgery may affect expression of numerous genes involved in different metabolic pathways and consequently induce functional and taxonomic changes in gut microbial communities. The role nutritional genomics plays in responses to weight loss after bariatric surgery is evident. Better understanding of the molecular pathways involved in this process is necessary for successful weight management and maintenance.

  6. Evidence for the different physiological significance of the 6- and 2-minute walk tests in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Motl Robert W

    2012-03-01

    Full Text Available Abstract Background Researchers have recently advocated for the 2-minute walk (2MW as an alternative for the 6-minute walk (6MW to assess long distance ambulation in persons with multiple sclerosis (MS. This recommendation has not been based on physiological considerations such as the rate of oxygen consumption (V·O2 over the 6MW range. Objective This study examined the pattern of change in V·O2 over the range of the 6MW in a large sample of persons with MS who varied as a function of disability status. Method Ninety-five persons with clinically-definite MS underwent a neurological examination for generating an Expanded Disability Status Scale (EDSS score, and then completion of the 6MW protocol while wearing a portable metabolic unit and an accelerometer. Results There was a time main effect on V·O2 during the 6MW (p = .0001 such that V·O2 increased significantly every 30 seconds over the first 3 minutes of the 6MW, and then remained stable over the second 3 minutes of the 6MW. This occurred despite no change in cadence across the 6MW (p = .84. Conclusions The pattern of change in V·O2 indicates that there are different metabolic systems providing energy for ambulation during the 6MW in MS subjects and steady state aerobic metabolism is reached during the last 3 minutes of the 6MW. By extension, the first 3 minutes would represent a test of mixed aerobic and anaerobic work, whereas the second 3 minutes would represent a test of aerobic work during walking.

  7. Valor de la grasaepicárdica en el diagnóstico de aterosclerosiscoronariaprevio a cirugíavalvular/ Significance of epicardial fat in the diagnosis of coronary atherosclerosis before heart valve surgery

    Directory of Open Access Journals (Sweden)

    Joanna de Zayas Galguera

    2015-12-01

    Full Text Available Introduction: Epicardial fat has been shown to be related not only with clinical atherosclerosis, but also with subclinical atherosclerosis. Objective: To determine the significance of epicardial fat in the diagnosis of coronary atherosclerosis in patients with valvular heart disease. Method: The study included 62 patients scheduled for valve replacement surgery who had previously undergone invasive coronary angiography. Before surgery, epicardial fat measurement was performed by echocardiogram. Sensitivity, specificity, and positive and negative predictive values were determined, as well as the validity index andlikelihood ratios for positive and negative tests. Results: 88.7% of patients with heart valve disease had no lesions in the coronary arteries. The most relevant parameters obtained from the measurement of epicardial fat were 78% sensitivity and 93% negative predictive value, and a ratio of positive and negative likelihood of 2.23 and 0.34 respectively. Conclusions: The group of patients with significant coronary lesions showed higher levels of epicardial fat than the group without coronary lesions. It confirms the diagnostic validity of this test for the detection of coronary atherosclerosis in the study patients.

  8. To operate or not--the impact of a lecture on radical glioblastoma surgery and different treatment options on decision-making for oneself and patients.

    Science.gov (United States)

    Mathiesen, Tiit

    2013-08-01

    Clinical decision-making involves a complex interaction between patients and caregivers. The medical knowledge and values of caregivers are essential for treatment recommendations. This study was undertaken to evaluate treatment recommendations by a group of Scandinavian neurosurgeons before and after an expert lecture on glioblastoma surgery. An interactive voting system was used to record responses to four questions regarding glioblastoma management before and after a 25-min lecture on the benefit of radical glioblastoma surgery. The majority of the audience aimed at radical surgery combined with radiotherapy before (76%) and after (88%) the lecture. The proportion who recommended immediate postoperative follow-up by MRI increased from 34% to 75%. Fourteen percent (before) and 45% (after) recommended renewed surgery to remove small residuals in patients, while 52% (before) and 60% (after) would have wanted to be re-operated if they themselves had been patients. The views on optimum management differed widely in a relatively homogeneous group of neurosurgeons. The lecture had a major impact on decision-making. A large proportion of the attendees recommended different management strategies for themselves and for their patients. The findings indicated the need to analyze the evaluation of medical knowledge, discuss the ethics of decision-making and encourage second opinions for serious neurosurgical decisions.

  9. Comparison of endoscopic surgery and open surgery for gluteal muscle contracture.

    Science.gov (United States)

    Fu, Dehao; Yang, Shuhua; Xiao, Baojun; Wang, Hong; Meng, Chunqing

    2011-01-01

    To compare the clinical effects of endoscopic surgeries with traditional open surgeries in the treatment of gluteal muscle contracture and discuss their indications and value. In this retrospective study, 50 patients received traditional open surgeries and 52 received endoscopic surgeries. The 2 groups were compared in terms of surgery duration, incision lengths, postsurgical pain, complications, off-bed activity times, hospitalization duration, clinical outcome, and 1-year recurrence rates. The endoscopic surgery group was significantly superior to the open surgery group in regard to incision length, postsurgical pain, off-bed activity time, hospitalization duration, and patient cosmetic satisfaction. Differences were not statistically significant for the surgery duration, complications, clinical outcome, or the 1-year recurrence rate. All the endoscopic surgery group patients stated that they would choose endoscopic surgery again. The endoscopic release of gluteal muscle contracture is safe and reliable, with the advantages of less trauma and pain, shorter operative time, earlier rehabilitation, and return of functional activities. Its application, though, should be carefully controlled based on the indications. It is applicable to degree I and II patients, but may be used only very cautiously in degree III patients. Level III.

  10. Comparison of two different doses of dexmedetomidine infusion on post-operative pain and sedation in patients undergoing laparoscopic surgery

    Directory of Open Access Journals (Sweden)

    Tanmay Tiwari

    2014-12-01

    Conclusion: The perioperative infusion of Dex may be an attractive option during laparoscopic surgery as it, offered better control of intraoperative and post-operative hemodynamics, and decreased post-operative pain level and better sedation scores, as compared with control. [Int J Basic Clin Pharmacol 2014; 3(6.000: 1052-1056

  11. Different cycle ergometer outcomes in severely obese men and women without documented cardiopulmonary morbidities before bariatric surgery

    NARCIS (Netherlands)

    Dolfing, JG; Dubois, EF; Wolffenbuttel, BHR; ten Hoor-Aukema, NM; Schweitzer, DH

    Study objectives: The number of severely obese patients undergoing bariatric surgery is increasing. No incremental cycle ergometer data are available in this category of patients. The current study was undertaken to provide information and to compare outcomes between severely obese men and women

  12. Difference in clinical outcome between total shoulder arthroplasty and reverse shoulder arthroplasty used in hemiarthroplasty revision surgery

    Directory of Open Access Journals (Sweden)

    Bas Pieter Hartel

    2015-01-01

    Conclusions: In this study, revision surgery showed poor to reasonable postoperative results and better clinical outcome for TSA. When a revision after HA was needed, and the soft-tissue component of the shoulder was intact, a TSA proved to be a preferable solution.

  13. Workforce issues in rural surgery.

    Science.gov (United States)

    Lynge, Dana Christian; Larson, Eric H

    2009-12-01

    Almost one quarter of America's population and one third of its landmass are defined as rural and served by approximately 20% of the nation's general surgeons. General surgeons are the backbone of the rural health workforce. There is significant maldistribution of general surgeons across regions and different types of rural areas. Rural areas have markedly fewer surgeons per population than the national average. The demography of the rural general surgery workforce differs substantially from the urban general surgery workforce, raising concerns about the extent to which general surgical services can be maintained in rural areas of the United States.

  14. Limited Evidence for Robot-assisted Surgery

    DEFF Research Database (Denmark)

    Broholm, Malene; Onsberg Hansen, Iben; Rosenberg, Jacob

    2016-01-01

    PURPOSE: To evaluate available evidence on robot-assisted surgery compared with open and laparoscopic surgery. METHOD: The databases Medline, Embase, and Cochrane Library were systematically searched for randomized controlled trials comparing robot-assisted surgery with open and laparoscopic...... surgery regardless of surgical procedure. Meta-analyses were performed on each outcome with appropriate data material available. Cochrane Collaboration's tool for assessing risk of bias was used to evaluate risk of bias on a study level. The GRADE approach was used to evaluate the quality of evidence...... of the meta-analyses. RESULTS: This review included 20 studies comprising 981 patients. The meta-analyses found no significant differences between robot-assisted and laparoscopic surgery regarding blood loss, complication rates, and hospital stay. A significantly longer operative time was found for robot...

  15. Patch in Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Alireza Alizadeh Ghavidel

    2014-06-01

    Full Text Available Introduction: Excessive bleeding presents a risk for the patient in cardiovascular surgery. Local haemostatic agents are of great value to reduce bleeding and related complications. TachoSil (Nycomed, Linz, Austria is a sterile, haemostatic agent that consists of an equine collagen patchcoated with human fibrinogen and thrombin. This study evaluated the safety and efficacy of TachoSil compared to conventional technique.Methods: Forty-two patients scheduled for open heart surgeries, were entered to this study from August 2010 to May 2011. After primary haemostatic measures, patients divided in two groups based on surgeon’s judgment. Group A: 20 patients for whom TachoSil was applied and group B: 22 patients that conventional method using Surgicel (13 patients or wait and see method (9 cases, were performed in order to control the bleeding. In group A, 10 patients were male with mean age of 56.95±15.67 years and in group B, 9 cases were male with mean age of 49.95±14.41 years. In case group 70% (14/20 of the surgeries were redo surgeries versus 100% (22/22 in control group.Results: Baseline characteristics were similar in both groups. In TachoSil group 75% of patients required transfusion versus 90.90% in group B (P=0.03.Most transfusions consisted of packed red blood cell; 2±1.13 units in group A versus 3.11±1.44 in group B (P=0.01, however there were no significant differences between two groups regarding the mean total volume of intra and post-operative bleeding. Re-exploration was required in 10% in group A versus 13.63% in group B (P=0.67.Conclusion: TachoSil may act as a superior alternative in different types of cardiac surgery in order to control the bleeding and therefore reducing transfusion requirement.

  16. Lung surgery

    Science.gov (United States)

    ... Pneumonectomy; Lobectomy; Lung biopsy; Thoracoscopy; Video-assisted thoracoscopic surgery; VATS ... You will have general anesthesia before surgery. You will be asleep and unable to feel pain. Two common ways to do surgery on your lungs are thoracotomy and video- ...

  17. Cataract Surgery

    Science.gov (United States)

    ... and Videos: What Do Cataracts Look Like? Cataract Surgery Written By: Kierstan Boyd Reviewed By: Elena M ... how they work. What to expect with cataract surgery Before surgery: Your ophthalmologist will measure your eye ...

  18. Quantitative Superresolution Microscopy Reveals Differences in Nuclear DNA Organization of Multiple Myeloma and Monoclonal Gammopathy of Undetermined Significance

    NARCIS (Netherlands)

    Sathitruangsak, C.; Righolt, C.H.; Klewes, L.; Tammur, P.; Ilus, T.; Tamm, A.; Punab, M.; Olujohungbe, A.; Mai, S.

    2015-01-01

    The mammalian nucleus has a distinct substructure that cannot be visualized directly by conventional microscopy. In this study, the organization of the DNA within the nucleus of multiple myeloma (MM) cells, their precursor cells (monoclonal gammopathy of undetermined significance; MGUS) and control

  19. Clinically significant and practical! Enhancing precision does make a difference. Reply to McGlinchey and Jacobson, Hsu, and Speer

    NARCIS (Netherlands)

    Hageman, WJJM; Arrindell, WA

    1999-01-01

    Based on a secondary analysis of the Jacobson and Truax [Jacobson, N.S. & Truax, P. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12-19.] data using both their own traditional approach

  20. Clinically significant and practical! Enhancing precision does make a difference. Reply to McGlinchey and Jacobson, Hsu, and Speer

    NARCIS (Netherlands)

    Hageman, WJJM; Arrindell, WA

    1999-01-01

    Based on a secondary analysis of the Jacobson and Truax [Jacobson, N.S. & Truax, P. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12-19.] data using both their own traditional approach

  1. [Different explanatory models for addictive behavior in Turkish and German youths in Germany: significance for prevention and treatment].

    Science.gov (United States)

    Penka, S; Krieg, S; Hunner, Ch; Heinz, A

    2003-07-01

    Due to cultural and social barriers, immigrants seldom frequent centers for information, counseling, and treatment of addictive disorders. We examine cultural differences in the explanatory models of addictive behavior among Turkish and German youths in Germany with statistical devices that map the concepts associated with problems of addiction. Relevant differences were found between the disorder concepts of Turkish and German youth. German but not Turkish youths classified eating disorders among severe addictive disorders and associated them with embarrassment and shame. Concerning substance abuse, German but not Turkish youths clearly differentiated between illegal drug abuse and the abuse of alcohol and nicotine. Nearly half of all Turkish youths rejected central medical concepts such as "physical dependence" or "reduced control of substance intake" as completely inadequate to characterize problems of addictive behavior. Preventive information programs must consider these differences and use concepts that are accepted and clearly associated with addictive behavior by immigrant populations.

  2. Significant geological engineering assessment salt massif, using them as a medium for the construction of underground objects for different purposes

    Directory of Open Access Journals (Sweden)

    Bosevskaja L,P.

    2010-06-01

    Full Text Available At present time rock salt bodies are considered to be not only an object for mining operations (rock salt but also a favorable geological environment for allocating different under-ground objects. Yet to this day there is no generally accepted synergetic system of engineering-geological estimation of rock salt bodies. In the paper given they propose underlying principles of system approach to solving issues of keeping equilibrium system under creating man-caused cavities of different purposes in rock salt bodies.

  3. No significant differences in peritoneal fluid handling in children using pH-neutral or acidic solutions

    NARCIS (Netherlands)

    Nourse, Peter; de Kar, Nicole C. A. J. van; Willems, Hans L.; Schroeder, Cornelis H.

    2006-01-01

    Objectives: Differences in peritoneal fluid handling in the acute setting can be expected if children are converted to pH-neutral dialysis solutions because conventional acidic solutions exert toxic effects on peritoneal mesothetial cells and microcirculation. Peritoneal fluid kinetics was therefore

  4. Quantitative Superresolution Microscopy Reveals Differences in Nuclear DNA Organization of Multiple Myeloma and Monoclonal Gammopathy of Undetermined Significance

    OpenAIRE

    Sathitruangsak, C.; Righolt, C.H.; Klewes, L.; Tammur, P.; Ilus, T.; Tamm, A; Punab, M.; Olujohungbe, A; Mai, S.

    2015-01-01

    ABSTRACT The mammalian nucleus has a distinct substructure that cannot be visualized directly by conventional microscopy. In this study, the organization of the DNA within the nucleus of multiple myeloma (MM) cells, their precursor cells (monoclonal gammopathy of undetermined significance; MGUS) and control lymphocytes of the representative patients is visualized and quantified by superresolution microscopy. Three‐dimensional structured illumination microscopy (3D‐SIM) increases the spatial r...

  5. Proteomic analysis of seedling roots of two maize inbred lines that differ significantly in the salt stress response.

    Directory of Open Access Journals (Sweden)

    Dezhou Cui

    Full Text Available Salinity is a major abiotic stress that limits plant productivity and quality throughout the world. Roots are the sites of salt uptake. To better understand salt stress responses in maize, we performed a comparative proteomic analysis of seedling roots from the salt-tolerant genotype F63 and the salt-sensitive genotype F35 under 160 mM NaCl treatment for 2 days. Under salinity conditions, the shoot fresh weight and relative water content were significantly higher in F63 than in F35, while the osmotic potential was significantly lower and the reduction of the K+/Na+ ratio was significantly less pronounced in F63 than in F35. Using an iTRAQ approach, twenty-eight proteins showed more than 2.0- fold changes in abundance and were regarded as salt-responsive proteins. Among them, twenty-two were specifically regulated in F63 but remained constant in F35. These proteins were mainly involved in signal processing, water conservation, protein synthesis and biotic cross-tolerance, and could be the major contributors to the tolerant genotype of F63. Functional analysis of a salt-responsive protein was performed in yeast as a case study to confirm the salt-related functions of detected proteins. Taken together, the results of this study may be helpful for further elucidating salt tolerance mechanisms in maize.

  6. Clinical significance of fibromyalgia syndrome in different rheumatic diseases: Relation to disease activity and quality of life.

    Science.gov (United States)

    El-Rabbat M, Sarah; Mahmoud, Nermeen K; Gheita, Tamer A

    2017-04-11

    To describe the frequencies of fibromyalgia syndrome (FMS) in various rheumatic diseases; rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and Behçets disease (BD) patients and to study the relation to clinical manifestations and quality of life (QoL). 160 patients (50 RA, 50 SLE, 30 SSc and 30 BD) and matched corresponding healthy controls were included. Disease activity was assessed using disease activity score in 28 joints (DAS28) for RA, SLE Disease Activity index (SLEDAI), modified Rodnan skin score for SSc and BD Current Activity Form (BDCAF). The QoL was also recorded. Severity in FMS cases was estimated using the revised Fibromyalgia Impact Questionnaire score. In the RA, SLE, SSc and BD patients, FMS was found in 14%, 18%, 6.67% and 3.33% respectively compared to 2.1%, 3%, 3.3% and 0% in their corresponding controls. In RA patients, DAS28 was significantly higher in those with FMS (p=0.009) and significantly correlated with both Widespread Pain Index (WPI) (p=0.011) and Symptom Severity (SS) scale (p=0.012). The QoL scale in those with FMS was significantly worse (62.3±7.9) compared to those without (71.7±14.4) (p=0.023). In SLE patients, The WPI and SS both significantly correlated with the presence of thrombosis (r=0.28, p=0.049 and r=0.43, p=0.002 respectively). The SS scale tended to correlate with the SLEDAI (r=0.28, p=0.05). In BD patients, BDCAF and WPI significantly correlated (p=0.03). Fibromyalgia syndrome is more frequent in rheumatic diseases, could be related to the disease activity in RA and BD patients and to thrombosis in SLE and affected the QoL in RA. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  7. The Expression of miR-192 and Its Significance in Diabetic Nephropathy Patients with Different Urine Albumin Creatinine Ratio

    Directory of Open Access Journals (Sweden)

    Xiaoyu Ma

    2016-01-01

    Full Text Available Objective. To investigate the expression of miR-192 and its significance in diabetic nephropathy (DN patients. Methods. 464 patients with type 2 diabetes mellitus (T2DM were divided into normal albuminuria group (NA, n=157, microalbuminuria group (MA, n=159, and large amount of albuminuria group (LA, n=148. 127 healthy persons were selected as the control group (NC, n=127. The serum miR-192 levels were detected by Real-Time PCR and transforming growth factor-β1 (TGF-β1 and fibronectin (FN were detected by enzyme-linked immunosorbent assay. The relationships among these parameters were analyzed by Pearson correlation analysis and multiple linear regression analysis. Results. The miR-192 in the LA group was significantly lower than other groups, which was lower in the MA group than in the NA group (P<0.01. The TGF-β1 and FN in the LA group were significantly higher than other groups, which were higher in the MA group than in the NA group (P<0.01. The expression of miR-192 was negatively correlated with TGF-β1, FN, and Ln (UACR and miR-192, TGF-β1, and FN were independent relevant factors affecting Ln (UACR in T2DM (P<0.01. Conclusions. These findings indicate that the levels of miR-192 were lower accompanied by the decrease of urine albumin creatinine ratio (UACR and the association between miR-192 and nephritic fibrosis in DN.

  8. NS-398, Ibuprofen and COX-2 RNAi produce significantly different gene expression profiles in prostate cancer cells

    OpenAIRE

    John-Aryankalayil, Molykutty; Palayoor, Sanjeewani T.; Cerna, David; Falduto, Michael T.; Magnuson, Scott R.; Coleman, C. Norman

    2009-01-01

    Cyclooxygenase-2 (COX-2) plays a significant role in tumor development and progression. Nonsteroidal anti-inflammatory drugs (NSAIDs) exhibit potent anticancer effects in vitro and in vivo by COX-2 dependent and independent mechanisms. In this study, we used microarray analysis to identify the change of expression profile regulated by a COX-2 specific NSAID NS-398 (0.01 and 0.1mM), a non-specific NSAID ibuprofen (0.1 and 1.5mM) and RNA interference-mediated COX-2 inhibition (COX-2 RNAi) in PC...

  9. Comparison of intraocular pressure during the application of a liquid patient interface (FEMTO LDV Z8) for femtosecond laser-assisted cataract surgery using two different vacuum levels.

    Science.gov (United States)

    Ebner, Martina; Mariacher, Siegfried; Januschowski, Kai; Boden, Katrin; Seuthe, Anna-Maria; Szurman, Peter; Boden, Karl Thomas

    2017-08-01

    To evaluate intraocular pressure (IOP) using the application of a novel liquid patient interface for femtosecond laser-assisted cataract surgery with the FEMTO LDV Z8. IOP was evaluated in enucleated porcine eyes prior, during and after the application of the Femto LDV Z8 liquid patient interface (Ziemer Ophthalmic Systems, Switzerland) using intracameral cannulation (n=20), intravitreal cannulation (n=20), rebound tonometry (n=20) and indentation tonometry (n=20). Pressure was assessed prior vacuum, during vacuum (30 s, 1 min, 2 min, 3 min) and after releasing the vacuum (1 min and 2 min). Two groups with different predefined vacuum levels (350 mbar, 420 mbar) were investigated. Mean intracameral pressure (±SD) increased during vacuum application from 20 mm Hg to 52.00 mm Hg (±6.35mm Hg; p=0.005) and 45.18 mmHg (±4.34 mm Hg; p=0.005) for the 420 mbar and the 350 mbar vacuum levels, respectively. Mean intravitreal pressure increased from 20 mm Hg to 25.60 mm Hg (±9.85 mm Hg; p=0.058) and 28.10 mm Hg (±2.54 mm Hg; p=0.059) for the 420 mbar and the 350 mbar vacuum levels, respectively. Pressure values from indentation and rebound tonometry were in between intracameral and intravitreal values. Mean intracameral IOP was 18.1% higher (p=0.019) in the 420 mbar group compared with the 350 mbar group. During vacuum application of the liquid patient interface of the Femto LDV Z8 for femtosecond laser-assisted cataract surgery, IOP values were higher in the anterior chamber compared with the intravitreal pressure measurements. The higher predefined vacuum level (350 mbar vs 420 mbar) resulted in significant higher intracameral IOP. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Corneal topographic analysis after axcimer iaser keratorefractive surgery for correction of different degree of myopia%不同近视程度及准分子激光屈光术后角膜地形图分析

    Institute of Scientific and Technical Information of China (English)

    付玲玲; 宁波; 王星瑾; 曾伶; 盛向东

    2010-01-01

    Objective To analyze the change on corneal topography before and after excimer laser keratorefractive surgery for correction of different degree of myopia, and to investigate the corneal shape changes after excimer laser keratorefractive surgery for correction of myopia. Methods 159 patients received excimer laser keratorefractive surgery in our hospital were included in the retrospective study. Parameters refrecting corneal surface, such as SRI、SAI、CLY, were analyzed in SPSS 13.0 statistics software. Results As is indicated on the Corneal Topography of Myopia of different degree: There was significant difference in CYL (P <0.05 ),and no significant difference in SRI、 SAI of each group ( P >0.05 ); As is indicated on the corneal topography before and after excimer laser keratorefractive surgery: CYL、SRI 、SAI changed with statistical significance after operation (P <0.01 ). Conclusion Among the patients of different degree of myopia, there was no significant difference in surface regularity and symmetry, and corneal astigmatism increased with an increase in the degree of refractive error .But there was significant difference in surface regularity ,symmetry and corneal astigmatism after excimer laser keratorefractive surgery. Therefore, when excimer laser keratorefractive surgery for correction of myopia is performing, more attention should be paid to the change of corneal surface, which helps reduce the occurrence of visual quality and optical questions.%目的 分析不同近视程度患者的角膜地形图及准分子激光术前、术后角膜地形图的差异,了解不同近视程度及术后角膜表面形态的改变.方法 回顾性分析2004年在我院行准分子激光屈光性手术的159例患者的角膜地形图资料,比较SRI、SAI、CLY等反映角膜表面形态的参数,采用SPSS 13.0统计软件进行统计分析.结果 不同近视程度组间角膜地形图比较示:CYL的差异有统计学意义(P<0.05),而SRI、SAI

  11. Weight Loss Surgery (Bariatric Surgery) (For Parents)

    Science.gov (United States)

    ... to Be Smart About Social Media Weight Loss Surgery (Bariatric Surgery) KidsHealth > For Parents > Weight Loss Surgery (Bariatric Surgery) ... bariatric surgery might be an option. About Bariatric Surgery Bariatric surgery had its beginnings in the 1960s, ...

  12. The scope of plastic surgery

    African Journals Online (AJOL)

    2013-08-03

    Aug 3, 2013 ... areas of surgery (especially general surgery), plastic surgeons are arguably the .... Who do you feel are experts in laparoscopic surgery? e (general surgeons) a. Maxillofacial .... of pressure sore. ORIF = open reduction internal fixation. ... Plastic versus cosmetic surgery: What's the difference? Plast Reconstr.

  13. Morbidity and mortality of diabetes with surgery

    Directory of Open Access Journals (Sweden)

    L. L. Chuah

    2013-01-01

    Full Text Available The prevalence of Type 2 diabetes mellitus (T2DM has increased; as a result the number of patients with T2DM undergoing surgical procedures has also increased. This population is at high risk of macrovascular (cardiovascular disease, peripheral vascular disease or microvascular (retinopathy, nephropathy or neuropathy complications, both increasing their perioperative morbidity and mortality. Diabetes patients are more at risk of poor wound healing, respiratory infection, myocardial infarction, admission to intensive care, and increased hospital length of stay. This leads to increased inpatient costs. The outcome of perioperative glycaemia management remains a significant clinical problem without a universally accepted solution. The majority of evidence on morbidity and mortality of T2DM patients undergoing surgery comes from the setting of cardiac surgery; there was less evidence on non-cardiac surgery and bariatric surgery. Bariatric surgery is increasingly performed in patients with severe obesity complicated by T2DM, but is distinguished from general surgery as it immediately improves the glucose homeostasis postoperatively. The improvements in glycaemia are thought to be independent of weight loss and this requires different postoperative management. Patients usually have to follow specific preoperative diets which lead to improvement in glycaemia immediately before surgery. Here we review the available data on the mortality and morbidity of patients with T2DM who underwent elective surgery (cardiac, non-cardiac and bariatric surgery and the current knowledge of the impact that preoperative, intraoperative and postoperative glycaemic management has on operative outcomes.

  14. Minimally invasive colorectal resection is associated with significantly elevated levels of plasma matrix metalloproteinase 3 (MMP-3) during the first month after surgery which may promote the growth of residual metastases.

    Science.gov (United States)

    Shantha Kumara, H M C; Gaita, David J; Miyagaki, Hiromichi; Yan, Xiaohong; Herath, Sonali A C; Cekic, Vesna; Whelan, Richard L

    2014-12-01

    MMP-3, a member of the matrix metalloproteinase (MMP) family, is involved in the breakdown of the extracellular matrix in tissue remodeling and may also play a role in cancer progression and metastasis. Minimally invasive colorectal resection (MICR) may increase plasma MMP-3 levels directly via surgical trauma or indirectly due to surgery-associated elevations in TNF-α and IL1 which are regulators of MMP-3. This study's purpose was to evaluate plasma MMP-3 levels during the first month after MICR for colorectal cancer. Patients enrolled in an IRB approved data/plasma bank who underwent elective MICR for CRC. Blood plasma samples had been collected preoperatively, on postoperative day (POD) 1, 3 and at varying postoperative time points and were stored at -80 °C. The late samples (POD 7-41) were bundled into 7 day time blocks and considered as single time points. MMP-3 levels were analyzed in duplicate via ELISA and the results reported as mean ± SD. The paired t test was used for analysis (significance, p MICR met the inclusion criteria. The mean PreOp MMP-3 level was 14.9 ± 7.8 ng/ml (n = 73). Significantly elevated mean plasma levels were noted on POD 1 (21.4 ± 14.7 ng/ml, n = 73, p MICR for CRC. The early postoperative increase in MMP-3 levels may be due to the surgery-related acute inflammatory response; the elevation noted during weeks 2-3 may be related to wound healing. Increased MMP-3 levels may promote metastases or the growth of residual cancer.

  15. Cytogenetical and morphological features reveal significant differences among Venezuelan and Brazilian samples of Mugil curema (Teleostei: Mugilidae

    Directory of Open Access Journals (Sweden)

    Mauro Nirchio

    2005-03-01

    Full Text Available Karyotype of M. curema from the Gulf of Mexico and Brazil have been reported as possessing chromosome complement with 2n=28 and FN=48, whereas specimens from Venezuela has been reported as possessing a diploid number 2n=24 and a conserved FN (48. Although at first sight this variation suggests the presence of a chromosomal intraspecific (interpopulational variability, the possibility that we are dealing with two different species was examined. This work revisit the karyotypes of M. curema from Venezuela and Brazil, including new data on C-banding, and NOR localization, and compares morphologic characteristics of samples from both localities. Thus, besides diploid number, the constitutive heterochromatin distribution and NORs location, mark other differences between M. curema Cytotype 1 (2n=28; FN=48 and Cytotype 2 (2n=24; NF=48. Moreover, morphologic comparison revealed differences in the scale counts and pectoral fin rays: 35 scales in the middle body line and 15 pectoral fin rays in specimens possessing the karyotype 2n=28, compared with 37-39 scales in the middle body line and 17 pectoral fin rays in specimens with the karyotype 2n=24. These differences lead us to suggest that both cytotypes are not related merely to geographic polytipic variations but could correspond to different species.Os cariótipos de M. curema do Golfo do México e do Brasil possuem 2n=28 cromossomos e NF=48. Espécimes da Venezuela, entretanto, apresentam um número diplóide de 28 cromossomos e um NF conservado (48. Apesar desta variação sugerir, a princípio, uma variabilidade intraespecífica (interpopulacional, a possibilidade de estarmos perante diferentes espécies foi investigada. O presente trabalho re-analisa os cariótipos de M. curema da Venezuela e do Brasil, incluindo novos dados sobre bandamento C e localização das NORs e compara caracteres merísticos e morfométricos de amostras de ambas as localidades. Assim, junto com o número cromossômico, a

  16. Flow Cytometry Method Analysis of Apoptosis: No Significant Difference Between EDTA and EDTA-free Trypsin Treatment Procedure.

    Science.gov (United States)

    Xu, Xiao-yan; Nie, Xiao-cui; Ma, Hai-ying; Song, Guo-qing; Zhang, Xiao-tong; Jin, Yu-nan; Yu, Yan-qiu

    2015-04-01

    Flow cytometry method (FCM) is a generally accepted tool to analyze apoptosis. Although apoptosis assay kit was applied by many companies, the manufacturers were not consistent with whether using Trypsin with EDTA to collect the adherent cells. In another words, the influence of EDTA on apoptotic ratio is not clear. In this work, we compared the proportion of apoptotic cells with EDTA or EDTA-free Trypsin treatment by FCM. We concluded that Trypsin with or without EDTA has little influence on the proportion of apoptotic cells. In addition, we found that the ratio of necrosis and apoptosis was different in cells collected by scraping. WAVE2 protein was analyzed as a typical example for movement related protein. WAVE2 expression is elevated in the EDTA Trypsin treated group, compared with EDTA-free Trypsin treatment and scrapping group.

  17. Significant differences in fecal microbiota are associated with various stages of glucose tolerance in African American male veterans.

    Science.gov (United States)

    Ciubotaru, Irina; Green, Stefan J; Kukreja, Subhash; Barengolts, Elena

    2015-11-01

    The importance of gut microbiota in pathogenesis of diabetes remains unknown. This study investigated the relationship between microbiota and metabolic markers in African American men (AAM) with prediabetes and hypovitaminosis D. The study was ancillary to a randomized trial of vitamin D supplementation with weekly ergocalciferol (50,000 IU) conducted in AAM veterans over 12 months (D Intervention in Veterans Affairs). Glycemic groups (Gr) were characterized based on changes in oral glucose tolerance between baseline and exit. Subjects with stable normal glucose tolerance were assigned to Gr-1 and those with stable prediabetes (impaired glucose tolerance and impaired fasting glucose) to Gr-2. Microbiota composition was analyzed in stool collected at the exit (n = 115) and compared between Gr-1 and Gr-2, as well as between the lowest and highest quartiles of dietary intake of energy and fat, hemoglobin A1c, and serum 25-hydroxyvitamin D (25[OH]D) level. Differences between Gr-1 and Gr-2 included the Bacteroidetes/Firmicutes and Bacteroidales/Clostridia ratios and differences in genera such as Ruminococcus and Dialister. Changes in specific taxa associated with the lowest and highest quartiles of 25(OH)D (eg, Ruminococcus, Roseburia, Blautia, Dorea) were clearly distinct from those of dietary intake (eg, Bacteroides, Bacteroides/Prevotella ratio) or A1c (eg, Faecalibacterium, Catenibacterium, Streptococcus). These findings suggest a novel interaction between microbiota and vitamin D and a role for microbiota in early stages of diabetes development. Although results suggest that specific taxa are associated with glycemic stability over time, a causative relationship between microbiota makeup and dysglycemia is still to be demonstrated. Published by Elsevier Inc.

  18. Clinical significance and value of applying psychological intervention for patients with plastic and aesthetic surgery%在整形美容受术者中应用心理干预的临床意义及价值

    Institute of Scientific and Technical Information of China (English)

    吴晶莉; 李冰

    2015-01-01

    Objective discuss mental psychological state of plastic surgery patients and clinical effect of applying psychological intervention during whole process of surgery.Method randomly divide 216 cases plastic surgery patients by odd and even numbers received in No. 211 hospital plastic beauty center into control and experimental group, and control group applied general treatment and nursing for preoperative, intraoperative and postoperative period, and experimental group applied cordial consulting during preoperative period, and music and psychology encourage and support during intraoperative period, and psychological intervention of rehabilitation guidance and regular follow-up for postoperative period. Apply anxiety self rating scale (SAS), depression self rating scale (SDS)and satisfaction degree investigation for both groups before and after operation, and evaluate function of psychological intervention in plastic and aesthetic surgery.Result scores of self rating scale after operation show signiifcant statistical difference comparing with those before operation(P<0.01).Conclusion applying psychological intervention for plastic surgery patients can improve their mental states, promote rehabilitation, improve success rate of operation and patients' satisfaction, reduce medical disputes.%目的 探讨整形美容手术者的心理状态及在受术者全程中应用心理干预的临床效果.方法 对211医院整形美容中心216例整形手术患者按就诊单双号随机分为对照组和试验组,对照组实施一般性术前、术中、术后常规诊疗护理,实验组除给予一般性诊疗护理外,术前进行亲切的问诊咨询,术中使用音乐和心理鼓励支持,术后给予康复指导和定期随访等心理干预.两组手术前后使用并采用焦虑自评量表(SAS)、抑郁自评量表(SDS)及满意度调查,评定心理干预在整形美容求术者中的作用.结果 术后各项自评量表分值与术前相比均存在明显差异(P<0

  19. Peripheral arterial volume distensibility: significant differences with age and blood pressure measured using an applied external pressure.

    Science.gov (United States)

    Zheng, Dingchang; Murray, Alan

    2011-05-01

    A new arterial distensibility measurement technique was assessed in 100 healthy normotensive subjects. Arterial transmural pressures on the whole right arm were reduced with a 50 cm long cuff inflated to 10, 20, 30 and 40 mmHg. The electrocardiogram, and finger and ear photoplethysmograms were recorded simultaneously. Arm pulse propagation time, pulse wave velocity (PWV) and arterial volume distensibility were determined. With a 40 mmHg reduction in transmural pressure, arm pulse propagation time increased from 61 to 83 ms, PWV decreased from 12 to 8 m s(-1) and arterial distensibility increased from 0.102% to 0.232% per mmHg (all P pressures, arterial distensibility was significantly related to resting mean arterial pressure (MAP), diastolic blood pressure (DBP) and age, and for systolic blood pressure at 30 and 40 mmHg (all P pressure, arterial distensibility fell by 54% for a MAP increase from 75 to 105 mmHg, 57% for a DBP increase from 60 to 90 mmHg and 47% for an age increase from 20 to 70 years. These changes were more than double than those without cuff pressure. Our technique showed that systemic volume distensibility of the peripheral arm artery reduced with age, with a greater effect at higher external and lower transmural pressures.

  20. Influence of different factors on risk of complications of tubal ligation surgery: Study of 1780 women admitted to 13 hospitals in Tehran

    Directory of Open Access Journals (Sweden)

    Sadat Hashemi SM

    2000-08-01

    Full Text Available Tubal ligation is one of the most effective and reliable methods of contraception and of successful program of birth control in Iran. Present study was done to evaluate factors affecting risk of complications during tubal ligation surgery. We studied 1780 women that had tubal ligation in 13 hospitals in Tehran during the years 1993-95. Data on operation were collected by questionnaire and analyzed using logistic regression method. Risk of complications was increased in women had had operation after vaginal therapy, in luteal phase, after cesarean section and in follicular phase, respectively. Modified pomery, pomery and parkland methods of operation were ascendingly related to increased risk of complications. Age, history of pelvic pain, method of anesthesia, incision size and time of operation were not significantly correlated with complications. Frequency of complications was higher in women that had other procedures during surgery. We suggest that tubal ligation be done after vaginal delivery and by modified pomery method.

  1. Differences in gestational weight gain between pregnancies before and after maternal bariatric surgery correlate with differences in birth weight but not with scores on the body mass index in early childhood

    DEFF Research Database (Denmark)

    Berglind, D; Willmer, M; Näslund, E

    2013-01-01

    Large maternal gestational weight gain (GWG) is associated with increased birth weight and increased risk of obesity in offspring, but these associations may be confounded by genetic and environmental factors. The aim was to investigate the effects of differences in GWG in all three trimesters on...... on differences in birth weight and in body mass index (BMI) scores at 4 and 6 years of age, within siblings born before and after bariatric surgery....

  2. Nucleotide sequence of XhoI O fragment of ectromelia virus DNA reveals significant differences from vaccinia virus.

    Science.gov (United States)

    Senkevich, T G; Muravnik, G L; Pozdnyakov, S G; Chizhikov, V E; Ryazankina, O I; Shchelkunov, S N; Koonin, E V; Chernos, V I

    1993-10-01

    The nucleotide sequence of the 3913 base pair XhoI O fragment located in an evolutionary variable region adjacent to the right end of the genome of ectromelia virus (EMV) was determined. The sequence contains two long open reading frames coding for putative proteins of 559 amino acid residues (p65) and 344 amino acid residues (p39). Amino acid database searches showed that p39 is closely related to vaccinia virus (VV), strain WR, B22R gene product (C12L gene product of strain Copenhagen), which belongs to the family of serine protease inhibitors (serpins). Despite the overall high conservation, differences were observed in the sequences of p39, B22R, and C12L in the site known to interact with proteases in other serpins, suggesting that the serpins of EMV and two strains of VV may all inhibit proteases with different specificities. The gene coding for the ortholog of p65 is lacking in the Copenhagen strain of vaccinia virus; the WR strain contains a truncated variant of this gene (B21R) potentially coding for a small protein (p16) corresponding to the C-terminal region of p65. p65 is a new member of the family of poxvirus proteins including vaccinia virus proteins A55R, C2L and F3L, and a group of related proteins of leporipoxviruses, Shope fibroma and myxoma viruses (T6, T8, T9, M9). These proteins are homologous to the Drosophila protein Kelch involved in egg development. Both Kelch protein and the related poxvirus proteins contain two distinct domains. The N-terminal domain is related to the similarly located domains of transcription factors Ttk, Br-C (Drosophila), and KUP (human), and GCL protein involved in early development in Drosophila. The C-terminal domain consists of an array of four to five imperfect repeats and is related to human placental protein MIPP. Phylogenetic analysis of the family of poxvirus proteins showed that their genes have undergone a complex succession of duplications, and complete or partial deletions.

  3. Making a difference? Societal entrepreneurship and its significance for a practical theological ecclesiology in a local Western Cape context

    Directory of Open Access Journals (Sweden)

    Ignatius Swart

    2011-03-01

    Full Text Available This article is concerned with the question of whether and how a local church or congregation can, as indissoluble dimension of its vocation as a Christian faith agent, make a difference by influencing the dynamics of social and economic change that are transforming the face and structures of ‘traditional’ social and religious life in its community. Based upon the authors’ own interest in the specific context of the Dutch Reformed congregation of Simondium in the Western Cape and the case study work that they have conducted in this context, an argument about the potential role of this congregation is developed through the conceptual lens of ‘societal entrepreneurship’. After exploring some recent thoughts on this concept in the literature, the authors use the results of their recently conducted case study work to show how the dynamics of a new entrepreneurial drive amongst long-established residents and newcomers in the Simondium region shape the social reality of both the region and the congregation in a forceful way. This insight leads the authors to develop a sociologically and theologically motivated argument about the way in which this changing reality offers newfound opportunities to the Simondium congregation to fulfil its Christian calling. As such, the notion of becoming an ‘entrepreneurial church’ is introduced and a more detailed perspective is offered on those factors that a contextually orientated practical theological ecclesiology should take into account in building the entrepreneurial model in the congregation.

  4. Histological and Ultrastructural Observation Reveals Significant Cellular Differences between Agrobacterium Transformed Embryogenic and Non-embryogenic Calli of Cotton

    Institute of Scientific and Technical Information of China (English)

    Hai-Hong Shang; Chuan-Liang Liu; Chao-Jun Zhang; Feng-Lian Li; Wei-Dong Hong; Fu-Guang Li

    2009-01-01

    Over the past few decades genetic engineering has been applied to improve cotton breeding. Agrobacterium medicated transformation is nowadays widely used as an efficient approach to introduce exogenous genes into cotton for genetically modified organisms. However, it still needs to be improved for better transformation efficiency and higher embryogenic callus induction ratios. To research further the difference of mechanisms for morphogenesis between embryogenic callus and non-embryogenic callus, we carried out a systematical study on the histological and cellular ultrastructure of Agrobacterium transformed calli. Results showed that the embryogenic callus developed nodule-like structures, which were formed by small, tightly packed, hemispherical cells. The surface of some embryogenic callus was covered with a flbrilar-like structure named extracellular matrix. The cells of embryogenic calli had similar morphological characteristics. Organelles of embryogenic callus cells were located near the nucleus, and chloroplasts degraded to proplastid-like structures with some starch grains, in contrast, the non-embryogenic calli were covered by oval or sphere cells or small clusters of cells. It was observed that cells had vacuolation of cytoplasm and plastids with a well organized endomembrane system. This study aims to understand the mechanisms of embryogenic callus morphogenesis and to improve the efficiency of cotton transformation in future.

  5. Histological and ultrastructural observation reveals significant cellular differences between Agrobacterium transformed embryogenic and non-embryogenic calli of cotton.

    Science.gov (United States)

    Shang, Hai-Hong; Liu, Chuan-Liang; Zhang, Chao-Jun; Li, Feng-Lian; Hong, Wei-Dong; Li, Fu-Guang

    2009-05-01

    Over the past few decades genetic engineering has been applied to improve cotton breeding. Agrobacterium medicated transformation is nowadays widely used as an efficient approach to introduce exogenous genes into cotton for genetically modified organisms. However, it still needs to be improved for better transformation efficiency and higher embryogenic callus induction ratios. To research further the difference of mechanisms for morphogenesis between embryogenic callus and non-embryogenic callus, we carried out a systematical study on the histological and cellular ultrastructure of Agrobacterium transformed calli. Results showed that the embryogenic callus developed nodule-like structures, which were formed by small, tightly packed, hemispherical cells. The surface of some embryogenic callus was covered with a fibrilar-like structure named extracellular matrix. The cells of embryogenic calli had similar morphological characteristics. Organelles of embryogenic callus cells were located near the nucleus, and chloroplasts degraded to proplastid-like structures with some starch grains. In contrast, the non-embryogenic calli were covered by oval or sphere cells or small clusters of cells. It was observed that cells had vacuolation of cytoplasm and plastids with a well organized endomembrane system. This study aims to understand the mechanisms of embryogenic callus morphogenesis and to improve the efficiency of cotton transformation in future.

  6. Expression and Significance of Bcl-2, Bax, Fas and Caspase-3 in Different Phases of Human Hemangioma

    Institute of Scientific and Technical Information of China (English)

    YANG Hong; DENG Chenguo; SHEN Shengguo; ZHANG Duanlian; YUYing

    2006-01-01

    The relationship between Bcl-2, Bax, Fas, caspase-3 and development of hemangioma and the molecular mechanism was investigated. By using immunohistochemical S-P method, proliferating cell nuclear antigen was detected. According to the classification of Mulliken in combination with PCNA expression, 27 cases were identified as proliferating hemangioma and 22 cases as involutive hemangioma. Five normal skin tissues around the tumor tissue served as controls. By using immunohistochemical technique, the expression of Bcl-2, Bax, Fax and Caspase-3 was detected. The cells expressing Bcl-2, Bax, Fax and cappase-3 were identified as hemangioma endothelia by immunohistochemical staining of Ⅷ factor. The average absorbance (A) and average positive area rate of Bcl-2, Bax, Fas and caspase-3 expression were measured by using HPIAS-2000 imaging analysis system. The results showed that the expression of Bcl-2 in the endothelia of proliferating hemangioma was significantly higher that in involutive degenerative hemangioma endothelia and vascular endothelia of normal skin tissue (P<0.01). The expression of Bax, Fas and Caspase-3 in the endothelia of involutive hemangioma was obviously higher than in the endothelia of proliferating hemangioma and normal skin tissue (P<0.01). The expression of BAx and Fas in endothelia of proliferating hemangioma was higher than in those of normal skin tissue (P<0.05). It was suggested that Bcl-2,Bax, Fas and caspase-3 might be involved in the development and involution of hemangioma. Bcl-2 could promote the growth of hemangioma by inhibiting apoptosis of endothelia. Bax, Fas and caspase-3 promote the switch of hemangioma from proliferation to involution by inducing the apoptosis of hemangioma endothelia.

  7. Garden and landscape-scale correlates of moths of differing conservation status: significant effects of urbanization and habitat diversity.

    Directory of Open Access Journals (Sweden)

    Adam J Bates

    Full Text Available Moths are abundant and ubiquitous in vegetated terrestrial environments and are pollinators, important herbivores of wild plants, and food for birds, bats and rodents. In recent years, many once abundant and widespread species have shown sharp declines that have been cited by some as indicative of a widespread insect biodiversity crisis. Likely causes of these declines include agricultural intensification, light pollution, climate change, and urbanization; however, the real underlying cause(s is still open to conjecture. We used data collected from the citizen science Garden Moth Scheme (GMS to explore the spatial association between the abundance of 195 widespread British species of moth, and garden habitat and landscape features, to see if spatial habitat and landscape associations varied for species of differing conservation status. We found that associations with habitat and landscape composition were species-specific, but that there were consistent trends in species richness and total moth abundance. Gardens with more diverse and extensive microhabitats were associated with higher species richness and moth abundance; gardens near to the coast were associated with higher richness and moth abundance; and gardens in more urbanized locations were associated with lower species richness and moth abundance. The same trends were also found for species classified as increasing, declining and vulnerable under IUCN (World Conservation Union criteria. However, vulnerable species were more strongly negatively affected by urbanization than increasing species. Two hypotheses are proposed to explain this observation: (1 that the underlying factors causing declines in vulnerable species (e.g., possibilities include fragmentation, habitat deterioration, agrochemical pollution across Britain are the same in urban areas, but that these deleterious effects are more intense in urban areas; and/or (2 that urban areas can act as ecological traps for some

  8. The adaptive significance of differences of root morphology, anatomy and physiology from three ecotypes of reed (Phragmites communis Trin.)

    Institute of Scientific and Technical Information of China (English)

    YuBing Liu; XinRong Li; ZhiShan Zhang; XiaoJun Li; Jin Wang

    2016-01-01

    Reeds are widely distributed in drought and high salt conditions of northwestern China. Leaf epidermal micromorpholo-gy, anatomy, chloroplast ultrastructure and physio-chemical characteristics due to long-term adaptation in the natural habitats of common reed (Phragmites communis Trin.) contrasted considerably among three different ecotypes: dune reed (DR), Gobi salt reed (GSR) and swamp reed (SR). The main objective of the present study is to determine the adapting characteristics of morphology, anatomy and physiological responses of thin roots in DR, GSR and SR. The results show that root length density was higher in SR and few root hairs were observed in DR. Cross-section anatomical features show that each ecotype has an endodermis and exodermis, while cortex thickness and proportion of root cortical aerenchyma and stele in root structure varied among the three ecotypes. The stele and xylem share a larger area in DR compared to GSR and SR. GSR has a large proportion of the cortex with radialized distribution of aerenchyma cells spacing, and the cortex has a peripheral, mechanically stiff ring in the exodermis. SEM and TEM microscope images show that GSR has a scle-renchyma ring with high lignification in the exodermis. The physio-chemical parameters show that GSR had a higher level of stress tolerance than DR. These findings indicate that developed water-absorbing tissues were largely distributed in the root structure of DR, and a main framework with supporting function spacing with aerenchyma was dominant in GSR in the long term adaptation to their natural habitats, respectively.

  9. Garden and Landscape-Scale Correlates of Moths of Differing Conservation Status: Significant Effects of Urbanization and Habitat Diversity

    Science.gov (United States)

    Bates, Adam J.; Sadler, Jon P.; Grundy, Dave; Lowe, Norman; Davis, George; Baker, David; Bridge, Malcolm; Freestone, Roger; Gardner, David; Gibson, Chris; Hemming, Robin; Howarth, Stephen; Orridge, Steve; Shaw, Mark; Tams, Tom; Young, Heather

    2014-01-01

    Moths are abundant and ubiquitous in vegetated terrestrial environments and are pollinators, important herbivores of wild plants, and food for birds, bats and rodents. In recent years, many once abundant and widespread species have shown sharp declines that have been cited by some as indicative of a widespread insect biodiversity crisis. Likely causes of these declines include agricultural intensification, light pollution, climate change, and urbanization; however, the real underlying cause(s) is still open to conjecture. We used data collected from the citizen science Garden Moth Scheme (GMS) to explore the spatial association between the abundance of 195 widespread British species of moth, and garden habitat and landscape features, to see if spatial habitat and landscape associations varied for species of differing conservation status. We found that associations with habitat and landscape composition were species-specific, but that there were consistent trends in species richness and total moth abundance. Gardens with more diverse and extensive microhabitats were associated with higher species richness and moth abundance; gardens near to the coast were associated with higher richness and moth abundance; and gardens in more urbanized locations were associated with lower species richness and moth abundance. The same trends were also found for species classified as increasing, declining and vulnerable under IUCN (World Conservation Union) criteria. However, vulnerable species were more strongly negatively affected by urbanization than increasing species. Two hypotheses are proposed to explain this observation: (1) that the underlying factors causing declines in vulnerable species (e.g., possibilities include fragmentation, habitat deterioration, agrochemical pollution) across Britain are the same in urban areas, but that these deleterious effects are more intense in urban areas; and/or (2) that urban areas can act as ecological traps for some vulnerable species of

  10. Advanced laparoscopic bariatric surgery Is safe in general surgery training.

    Science.gov (United States)

    Kuckelman, John; Bingham, Jason; Barron, Morgan; Lallemand, Michael; Martin, Matthew; Sohn, Vance

    2017-05-01

    Bariatric surgery makes up an increasing percentage of general surgery training. The safety of resident involvement in these complex cases has been questioned. We evaluated patient outcomes in resident performed laparoscopic bariatric procedures. Retrospective review of patients undergoing a laparoscopic bariatric procedure over seven years at a tertiary care single center. Procedures were primarily performed by a general surgery resident and proctored by an attending surgeon. Primary outcomes included operative volume, operative time and leak rate with perioperative outcomes evaluated as secondary outcomes. A total of 1649 bariatric procedures were evaluated. Operations included laparoscopic bypass (690) and laparoscopic sleeve gastrectomy (959). Average operating time was 136 min. Eighteen leaks (0.67%) were identified. Graduating residents performed an average of 89 laparoscopic bariatric cases during their training. There were no significant differences between resident levels with concern to operative time or leak rate (p 0.97 and p = 0.54). General surgery residents can safely perform laparoscopic bariatric surgery. When proctored by a staff surgeon, a resident's level of training does not significantly impact leak rate. Published by Elsevier Inc.

  11. Effects of carbon dioxide pneumoperitoneum on heart rate variability in different laparoscopic surgery%CO2气腹对心率变异性的影响

    Institute of Scientific and Technical Information of China (English)

    陈永权; 付群; 金孝岠

    2013-01-01

    Objective To observe the effects of carbon dioxide pneumoperitoneum on heart rate variability in different laparoscopic surgery. Methods Forty-six patients ASA grade I or Ⅱ for elective laparoscopic cholecysteotomy (n = 2,group LC) or gynecological laparoscopy(n = 24,group LG) were enrolled in this study. Pneumoperitoneum was introduced by CO2 inflatioa Intra-abdominal of pressure was maintained at 11-13 mm Hg. The changes of heart rate variability (HRV)with low frequency(LF), high frequency (HF), normalized unit low frequency(LFnu), normalized unit high frequency(HFnu) and low frequency/high frequency ratio (LF/HF) were recorded before anesthesia (To),just at insufflationsCT1 ), 5,10,30 min after inflation (T2-T4) and 5 min after deflation(T5). Power spectral analysis of HRV was conducted on 256-beat R-R interval segments of interpolated heart rate by using the fast Fourier transformatioa Total spectra power(TP),low frequency power (LF)and high frequency power(HF) were calculated by integrating the power spectra between 0-0. 5 Hz,0. 03-0.15 Hz and 0.15-0. 35 Hz. Results LF, LFnu and LF/HF ratio, but not HF and HFnu were significantly increased at T2-T5 as compared with the baseline values at To in group LC(P<0.05 or P<0. 01). HF and HF were significantly decreased at T2-T5 as compared with the baseline values at To in group LG(P<0.05 or P<0. 01)and LF/HF ratio were significantly increased(P<0. 05 or P<0. 01), but LF and LFnu were not significantly different Compared with group LC, LF, LFnn, HF and HFnn in group LG at T2-T5 were obviously decreased (P<0. 05 or P<0.01). Conclusion Increased LF/HF ratio reflects the sympathetic/parasympathetic tension imbalance during both different laparoscopic surgeries. CO2 pneumoperitoneum increases sympathetic cardiac nerve activity in both laparoscopic surgeries.%目的 观察不同腹腔镜手术CO2气腹建立时对心率变异性(HRV)的影响.方法 选择择期行腹腔镜手术患者46例,ASA Ⅰ

  12. THE PROGNOSIS SIGNIFICANCE OF CATHEPSIN-D EXPRESSION IN THE DIFFERENT LOCATIONS IN AXILLARY NODES NEGATIVE CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    NIU; Yun

    2001-01-01

    [1]Garcia M, Platet N, Liaudet Estradiol, et al. Biological and clinical significance of cathepsin D in breast cancer metastasis [J]. Stem Cells 1996; 14:642.[2]Johnson MD, Torri JA, Lippman ME, et al. The role of cathepsin D in the invasiveness of human breast cancer cells [J]. Cancer Res 1993; 53: 873.[3]Duffy MJ. Proteases as prognostic markers in cancer [J]. Clin Cancer Res 1996; 2:613.[4]Westley BR, May FE. Cathepsin D and breast cancer [J]. Eur J Cancer 1996; 32A:7.[5]Riley LB, Lange MK, Browne RJ, et al. Analysis of cathepsin D in human breast cancer: usefulness of the processed 31 kDa active form of the enzyme as a prognostic indicator in node-negative and node-positive patients [J]. Breast Cancer Res Treat 2000; 60:173.[6]Fu XL. Histopathologic diagnosis. Chinese Common Malignant Tumor Diagnosis and Treatment Rule. Breast Carcinoma Volume [M]. 2nd ed. Beijing: Beijing Medical University and Chinese Xiehe Medical University Union Publisher, 1999; 23.[7]Yang SQ. Health Statistics [M]. 3rd ed. Beijing: People Health Publisher, 1998; 131.[8]Bittl A, Nap M, Jager W, et al. Immuno-histochemical detection of P-glycoprotein on frozen and paraffin-embedded tissue sections of normal and malignant tissues [J]. Anticancer Res 1995; 15:1007.[9]Isola J, Weitz S, Visakorpi T, et al. Cathepsin D expression detected by immunohistochemistry has independent prognostic value in axillary node-negative breast cancer [J]. J Clin Oncol 1993; 11:36.[10]Castiglioni T, Merino MJ, Elsner B, et al. Immunohistochemical analysis of cathepsins D, B, and L in human breast cancer [J]. Hum Pathol 1994; 25:857.[11]Montcourrier P, Mangeat PH, Valembois C, et al. Characterization of very acidic phagosomes in breast cancer cells and their association with invasion [J]. J Cell Sci 1994; 107:238l.[12]Foekens JA, Look MP, Bolt de Vries J, et al. Cathepsin-D in primary breast cancer: prognostic evaluation involving 2810 patients [J]. Br J Cancer 1999

  13. Systematic review of the surgery-first approach in orthognathic surgery.

    Science.gov (United States)

    Huang, Chiung Shing; Hsu, Sam Sheng-Pin; Chen, Yu-Ray

    2014-01-01

    The surgery-first approach in orthognathic surgery has recently created a broader interest in completely eliminating time-consuming preoperative orthodontic treatment. Available evidence on the surgery-first approach should be appraised to support its use in orthognathic surgery. A MEDLINE search using the keywords "surgery first" and "orthognathic surgery" was conducted to select studies using the surgery-first approach. We also manually searched the reference list of the selected keywords to include articles not selected by the MEDLINE search. The search identified 18 articles related to the surgery-first approach. There was no randomized controlled clinical trial. Four papers were excluded as the content was only personal opinion or basic scientific research. Three studies were retrospective cohort studies in nature. The other 11 studies were case reports. For skeletal Class III surgical correction, the final long-term outcomes for maxillofacial and dental relationship were not significantly different between the surgery-first approach and the orthodontics-first approach in transverse (e.g., intercanine or intermolar width) dimension, vertical (e.g., anterior open bite, lower anterior facial height) dimension, and sagittal (e.g., anterior-posterior position of pogonion and lower incisors) dimension. Total treatment duration was substantially shorter in cases of surgery-first approach use. In conclusion, most published studies related to the surgery-first approach were mainly on orthognathic correction of skeletal Class III malocclusion. Both the surgery-first approach and orthodontics-first approach had similar long-term outcomes in dentofacial relationship. However, the surgery-first approach had shorter treatment time.

  14. Systematic review of the surgery-first approach in orthognathic surgery

    Directory of Open Access Journals (Sweden)

    Chiung Shing Huang

    2014-08-01

    Full Text Available The surgery-first approach in orthognathic surgery has recently created a broader interest in completely eliminating time-consuming preoperative orthodontic treatment. Available evidence on the surgery-first approach should be appraised to support its use in orthognathic surgery. A MEDLINE search using the keywords "surgery first" and "orthognathic surgery" was conducted to select studies using the surgery-first approach. We also manually searched the reference list of the selected keywords to include articles not selected by the MEDLINE search. The search identified 18 articles related to the surgery-first approach. There was no randomized controlled clinical trial. Four papers were excluded as the content was only personal opinion or basic scientific research. Three studies were retrospective cohort studies in nature. The other 11 studies were case reports. For skeletal Class III surgical correction, the final long-term outcomes for maxillofacial and dental relationship were not significantly different between the surgery-first approach and the orthodontics-first approach in transverse (e.g., intercanine or intermolar width dimension, vertical (e.g., anterior open bite, lower anterior facial height dimension, and sagittal (e.g., anterior-posterior position of pogonion and lower incisors dimension. Total treatment duration was substantially shorter in cases of surgery-first approach use. In conclusion, most published studies related to the surgery-first approach were mainly on orthognathic correction of skeletal Class III malocclusion. Both the surgery-first approach and orthodontics-first approach had similar long-term outcomes in dentofacial relationship. However, the surgery-first approach had shorter treatment time.

  15. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ...

  16. Dental Implant Surgery

    Science.gov (United States)

    ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ...

  17. A COMPARATIVE STUDY OF THE DIFFERENT DOSES OF MAGNESIUM SULPHATE AND FENTANYL AS ADJUVANTS TO BUPIVACAINE [0.5% HEAVY] FOR LOWER ABDOMINAL SURGERIES UNDER SUBARACHNOID BLOCK

    Directory of Open Access Journals (Sweden)

    Syed Ali

    2016-04-01

    Full Text Available BACKGROUND Spinal anaesthesia is the most commonly used technique for infraumbilical surgeries and it has some disadvantages, such as a short duration of motor blockade and post-operative analgesia. This study was designed to evaluate the effects of additive agents of fentanyl and magnesium sulphate along with Bupivacaine for prolongation of analgesia and motor blockade during spinal anaesthesia for infraumbilical surgeries. METHODS This study was conducted in 60 patients of both sexes of ASA physical status I and II scheduled for infraumbilical surgeries. Patients were randomly divided into two groups and were given the drugs intrathecally as per group distribution; Group BFbupivacaine 15 mg (0.5% heavy with fentanyl 25 μg, Group BM-bupivacaine 15 mg (0.5% heavy with magnesium 100 mg intrathecal. RESULTS There was a similar increase in duration of analgesia in Group BF (378.21 min. as compared to Group BM (331.12 min.. In Group (BF, all haemodynamic parameters are decreased by more than 19%. There was an increase in duration of motor blockade more in Group (BF compared to Group (BM. CONCLUSION In conclusion, (100 mg magnesium sulphate or (25 μg fentanyl as adjuvants with bupivacaine to spinal anaesthesia. Both drugs are significantly prolonging the duration of both sensory block and analgesia, but magnesium sulphate provides better haemodynamic stability than fentanyl.

  18. Comparison of different techniques of cataract surgery in bacterial contamination of the anterior chamber in diabetic and non-diabetic population

    Directory of Open Access Journals (Sweden)

    M Ashok Kumar

    2012-01-01

    Full Text Available Aim : To compare the bacterial contamination of the anterior chamber (AC between manual small incision cataract surgery (SICS and phacoemulsification (Phaco. To study the conjunctival flora and bacterial contamination of AC between well-controlled diabetics and non-diabetics. Materials and Methods : Three hundred and sixty-eight patients were randomized to manual SICS and Phaco. Sixty-eight patients were excluded for not completing follow-up or for intraoperative complications like posterior capsule rupture. One hundred and fifty patients in each group were finally analyzed. Conjunctival swabs were taken on admission, after one day of topical ofloxacin and 15 min after 5% Povidone Iodine (PI instillation. AC aspirate at the end of the surgery was also cultured. Results : Fifty-six (18.66% patients had positive conjunctival swab on admission which was reduced to 19 (6.33% with topical ofloxacin and to five (1.66% with instillation of 5% PI. AC contamination in both manual SICS and Phaco was 0.66%. The conjunctival flora in diabetics was similar to non-diabetics. None of the diabetics had AC contamination. Statistical analysis was performed by Chi-Square test (with Yates′ correction. Conclusion : Statistically significant reduction in conjunctival flora was achieved with topical ofloxacin and 5% PI instillation and AC contamination in both manual SICS and Phaco was minimal (0.66%. Well-controlled diabetics who underwent cataract surgery in this study had similar conjunctival flora and AC contamination as non-diabetics.

  19. Effect of different incisions in strabismus surgery on the tear film%斜视手术不同切口对泪膜功能的影响

    Institute of Scientific and Technical Information of China (English)

    谭业双; 周霞; 袁均; 王志斌

    2012-01-01

    Objective To investigate the effect of different incisions on tear film after strabismus surgery. Methods Tear film was monitored in 59 patients (59eyes) after strabismus surgery. Patients were divided into two groups according to the type of incision: group A (30 patients,30 eyes) with swan incision or limbus incision and group B (29 patients, 29 eyes) with Parks incision. Symptoms of dry eye, Schumer I test (SIt), break-uptime (BUT), and cornea fluorescem staining (CFS) were observed at 1 days preoperatively and 1 week, 2weeeks and4 weeks postoperativery. The results wen analyzed with SPSS 10.0. Results (1)There was a large increase in symptoms of dry eye at 7 days and 14 days postopera-tivefy. The increase in group A was much greater than in group B and the difference wa" significant ( P 0.05). (2)There was a large increase in Sit at 7days and 14 days postoperatively. The increase in group A was much greater than in group B and the difference wag significant! P 0.05). (3) There was a large reduction in BUT at 7days and 14 days postoperatively. The reduction was more prolonged in group B compared to group A and the difference between the two groups was significant( P 0.05). (4)There was a large increase in CSF at 7days and 14 days postoperatively. There was a greater increase in group A compared to group B and the difference between the two groups was significant} P <0.05). However, there were no significant differences between the two groups at other times (p>0.05)conclustion The awan or limbus conjuoctival incision can significamly affect stability of tear film : Part. conjunctival incision has less effect.%目的 观察斜视患者行斜视矫正术后泪膜功能的变化,分析斜视矫正术不同切口对患者泪膜功能的影响.方法 对59例(59只眼)斜视患者行斜视矫正术,随机分为两组:A组30例(30只眼),行Swan结膜切口或Limbus切口;B组29例(29只眼),行Parks结膜切口.分别观察术前1d及术后7、14、28d患者干

  20. Cirugía: un contexto diferente de cuidado Cirurgia: um contexto diferente de cuidados Surgery: a different care concept

    Directory of Open Access Journals (Sweden)

    Ángela María Salazar Maya

    2011-07-01

    fundamental theory. Data were collected through observation, informal and formal interviews to 20 patients, 19 nursing assistants and 8 nurses working in different second level surgical settings in the Valle de Aburra. Results: a theoretical scheme comprising twelve categories arises from data collected. This study shall present the category comprised in the following context: Working and being in a different area. It comprises the following subcategories: attention attracted by the environment, entering, being operated and going out, working under stress and team working. Final considerations: the surgical context, as any sphere, has an influence on nursing care; it supposes challenges for the nursing team regarding interactions, as they should be efficient and effective. The patient's status, his/her vulnerability, the risk implied by the anesthetic and surgical procedure, plus the simultaneousness of tasks faced by the nursing team makes their work stressful; therefore, the surgery service requires a nursing team capable of working under stress.

  1. Change and clinical significance of coagulation function in patients with lower extremity deep venous thrombosis after gynecological pelvic surgery%妇科盆腔术后下肢深静脉血栓患者凝血功能变化及其临床意义

    Institute of Scientific and Technical Information of China (English)

    王宏丽; 张云

    2012-01-01

    clinical significance of coagulation function in patients with lower extremity deep venous thrombosis (LEDVT) after gynecological pelvic surgery. Methods; ACL - TOP automated coagulation analyzer was used to detect plasma prothrombin times (PT) , activated partial thromboplastin times (APTT) , plasma thrombin times (TT) , plasma fibrinogen (FIB) concentrations, and D - dimer levels in 30 patients with LEDVT after gynecological pelvic surgery (including 9 patients with cervical cancer, 6 patients with ovarian cancer, 8 patients with endometrial cancer, 5 patients with hysteromyoma, one patient with adenomyoma, and one patient with tubal pregnancy) and 58 patients without LEDVT (including 40 patients with gynecological malignant tumor and 18 patients withhysteromyoma) after gynecological pelvic surgery, then the results were compared with those of normal women (control group) after physical examination. Results: Before operation, FIB concentrations and D - dimer levels in the patients with LEDVT after gynecological pelvic surgery and the patients without LEDVT after gynecological pelvic surgery were statistically significantly higher than those in control group ( P 0.05) . After 24 hours, FIB concentration and D - dimer level in the patients with LEDVT after gynecological pelvic surgery were statistically significantly higher than those in the patients without LEDVT after gynecological pelvic surgery and control group (P 0.05) . After anticoagulant therapy, thrombolytic therapy, and anti - inflammatory therapy, all the patients were cured, no complications occurred. After recovery, there was no statistically significant difference in PT, APTT, TT, FIB, and D - dimer levels between the patients after gynecological pelvic surgery and control group (P > 0.05 ) . Conclusion: Coagulation function detection, especially FIB and D - dimer detection, has important effect for laboratory examination of patients with LEDVT after gynecological pelvic surgery, which can be used for early

  2. [Relationship between corneal surface temperature and air flow conditions during refractive laser eye surgery using three different excimer lasers].

    Science.gov (United States)

    Szekrényesi, Csaba; Sándor, Gábor László; Gyenes, Andrea; Kiss, Huba; Filkorn, Tamás; Nagy, Zoltán

    2016-10-01

    Thermal conditions during photorefractive keratectomy might be an important issue related to the corneal wound healing and long-term outcomes. Authors tried to find out the importance of temperature conditions during the treatment. One eye of 90 patients has been included into the study. Photorefractive keratoctomy was applied with Carl Zeiss MEL 70, MEL 80 and Wavelight Allegretto excimer lasers. EBRO TLC 730 infrared thermometer was used for the measurement of surface temperature of the cornea before epithelial removal, as well as before and after the treatment. Average age of the patients was 25.5 ± 3 yr. Average myopic correction was -3.2 ± 0.8 Dpt. Statistically significant difference was found in temperature change between MEL 80 and the other two types of excimer laser devices. Different air flow conditions of the smoke removal system might have an influence on changes of the corneal temperature during treatment, but the refractive results were not influenced by this issue. Orv. Hetil., 2016, 157(43), 1717-1721.

  3. Dietary analysis of Late Cenozoic Mexican equids from three different geographic/geologic settings using stable carbon isotopes: Coincidences, differences and paleobiologic significance

    Science.gov (United States)

    Pérez-Crespo, Víctor Adrian; Ferrusquía-Villafranca, Ismael; Bravo-Cuevas, Víctor Manuel; Morales-Puente, Pedro; Ruiz-González, José E.

    2016-03-01

    The development of Vertebrate Paleontology in Mexico is uneven, so that there is a strong bias in favor of Neogene/Quaternary mammals largely collected in the Trans-Mexican Volcanic Belt (TMVB hereafter) and Central Plateau (CeP hereafter) Morphotectonic Provinces [MP hereafter]; however, the time is ripe for pursuing research in other than taxonomic areas. Here we investigate C3/C4 plant consumption in the equid lineage in three such provinces, which provide different geographic/geologic and paleoecologic scenarios during the Barstovian, Hemphillian and Rancholabrean times. Our results show that the Barstovian equids from Oaxaca, Sierra Madre del Sur MP Cormohipparion aff. C. quinni, Merychippus cf. M. sejunctus and Pliohippus sp. largely fed on C3 plants, which were the chief food stuff of horses in Mexico, particularly in the Southeast. On the other hand, the Hemphillian equid from Guanajuato, CeP Astrohippus stocki, was an unbalanced C3/C4 mixed feeders in favor of C4 plants, a fact that indicates a profound plant diversification due to the inception and rapid diversification of C4 plants that occurred there at this time, as it occurred in temperate North America, resulting in the differential consumption of C4 plants over that of C3 plants. Such trend prevailed until the Rancholabrean, as born out by the inferred diet for Equus conversidens and Equus sp. from Hidalgo, TMVB. Clearly then, the coeval diet change observed in Mexico and temperate North America implies a correlative vegetation change resulting in the appearance and rapid diversification of C4 plants, which largely formed the preferred food stuff of equids since the Hemphillian, although some C3 plant consumption was maintained till the Rancholabrean. It should be noted that the development of hypsodonty in equids and many artiodactyls, has long been interpreted as the adaptive mammalian response to the new feeding conditions.

  4. Accreditation Council for Graduate Medical Education Case Log: General Surgery Resident Thoracic Surgery Experience

    Science.gov (United States)

    Kansier, Nicole; Varghese, Thomas K.; Verrier, Edward D.; Drake, F. Thurston; Gow, Kenneth W.

    2014-01-01

    Background General surgery resident training has changed dramatically over the past 2 decades, with likely impact on specialty exposure. We sought to assess trends in general surgery resident exposure to thoracic surgery using the Accreditation Council for Graduate Medical Education (ACGME) case logs over time. Methods The ACGME case logs for graduating general surgery residents were reviewed from academic year (AY) 1989–1990 to 2011–2012 for defined thoracic surgery cases. Data were divided into 5 eras of training for comparison: I, AY89 to 93; II, AY93 to 98; III, AY98 to 03; IV, AY03 to 08; V, AY08 to 12. We analyzed quantity and types of cases per time period. Student t tests compared averages among the time periods with significance at a p values less than 0.05. Results A total of 21,803,843 general surgery cases were reviewed over the 23-year period. Residents averaged 33.6 thoracic cases each in period I and 39.7 in period V. Thoracic cases accounted for nearly 4% of total cases performed annually (period I 3.7% [134,550 of 3,598,574]; period V 4.1% [167,957 of 4,077,939]). For the 3 most frequently performed procedures there was a statistically significant increase in thoracoscopic approach from period II to period V. Conclusions General surgery trainees today have the same volume of thoracic surgery exposure as their counterparts over the last 2 decades. This maintenance in caseload has occurred in spite of work-hour restrictions. However, general surgery graduates have a different thoracic surgery skill set at the end of their training, due to the predominance of minimally invasive techniques. Thoracic surgery educators should take into account these differences when training future cardiothoracic surgeons. PMID:24968766

  5. Aortic aneurysm disease vs. aortic occlusive disease - differences in outcome and intensive care resource utilisation after elective surgery

    DEFF Research Database (Denmark)

    Bisgaard, Jannie; Gilsaa, Torben; Rønholm, Ebbe;

    2013-01-01

    clamping is more pronounced in patients with aortic aneurysm disease, which may affect outcome. OBJECTIVES: The aim of this observational cohort study was to evaluate outcome after open elective abdominal aortic surgery, hypothesising a higher 30-day mortality, a higher incidence of postoperative organ...... dysfunction and a longer length of stay in patients with aortic aneurysm compared with aortic occlusive disease. DESIGN: Cohort observational study based on prospective registrations from national databases. SETTING: Eight Danish hospitals, including four university and four non-university centres, from 1...... or inotropes, ICU stay more than 24 h, hospital length of stay and mortality. RESULTS: Compared with aortic occlusive disease, more patients with aortic aneurysm disease had ICU stays more than 24 h (62 vs. 45%, P ...

  6. LAPAROSCOPIC GYNAEC SURGERIES – A RETROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Hiremath

    2013-10-01

    Full Text Available ABSTRACT : BACKGROUND: There has been a rapid worldwide adoption of laparoscopic procedures across many surgical specialt ies, most notably in Gynaecology. Unfortunately, the increased adoption of laparoscopic surgery has also been accompanied by a corresponding rise in the rates and types of complications reported. AIMS : To audit the different types of laparoscopic surgerie s and their complications and comparison with other routes of surgery. METHODS & MATERIALS : We have retrospectively analysed 285 laparoscopic surgeries and 306 other routes of surgery which were done at our institute from July 2011 to April 2013.We admit t he patients 1 - 2 days prior to surgery and a complete medical work - up of the patient is done for elective laparoscopic surgery .We defer laparoscopy for malignant conditions, uterine size more than 20 weeks, cervix flushed to the vagina or with history of m ore than 2 pelvic surgeries. Sub - fertile women, after an initial workup, are subjected to diagnostic laparoscopy with chromopertubation. For laparoscopic cystectomies, patients with ultrasono graphy findings suggestive of benign tumours are selected. RESULT S : We have performed 285 laparoscopic procedures over this time period till date. Majority of these cases are Laparoscopic Assisted Vaginal Hysterectomies (LAVH [111 – 38.9%], followed by laparoscopic surgeries for various benign ovarian conditions ( BOC [62 – 21%] and Diagnostic Laparoscopies ( DL with or without laparoscopic ovarian drilling ( LOD [59 cases – 20.7%]. Out of 111 LAVH, 3 patients had bladder injury [2.7%] ; Out of 285 cases that underwent laparoscopic procedures, 5 [1.75%] required conversi on to laparotomy. Overall operative complications including major and minor, are significantly higher in the abdominal surgery group as compared to the laparoscopic group ( p value= 0.001 CONCLUSION : Laparoscopy is a safe route for conventional surgery, with lesser intraoperative, immediate post

  7. Radical surgery compared with intracavitary cesium followed by radical surgery in cervical carcinoma stage IB

    Energy Technology Data Exchange (ETDEWEB)

    Tinga, D.J.; Bouma, J.; Aalders, J.G. (Dept. of Obstetrics and Gynaecology, State Univ. Hospital, Groningen (Netherlands)); Hollema, H. (Dept. of Pathology, State Univ. Hospital, Groningen (Netherlands))

    1990-01-01

    Forty-nine patients aged {le} 45 years, with cervical carcinoma stage IB ({le} 3 cm) were treated with either primary radical surgery (n = 26), or intracavitary irradiation followed by radical surgery (n = 23). With primary surgery, ovarian function had been preserved in 15 of the 25 patients, who were alive and well. Seven of the primary surgery patients were irradiated postoperatively and 2 others with a central recurrence were cured by irradiation. One other patient, who was not irradiated postoperatively, had an intestinal metastasis and died of the disease. If any of the adverse prognostic factors (as reported in the literature) had been considered as an indication for postoperative irradiation, 17 patients instead of 7 would have been irradiated after primary radical surgery. In the comparable group of 23 patients treated by intracavitary irradiation and radical surgery (and in 4 cases postoperative irradiation as well) there was no recurrence. There was no significant statistical difference between the treatment results in the cesium + surgery group and those who underwent primary radical surgery. Young patients with early cervical carcinoma without prognostic indicators for postoperative irradiation can benefit from primary radical surgery, because their ovarian function can be preserved. (authors).

  8. Comparative Analysis of High-Order Aberration After Different Corneal Refractive Surgeries%不同角膜屈光手术后高阶像差情况对比分析

    Institute of Scientific and Technical Information of China (English)

    聂新钢; 黄琰霞

    2016-01-01

    Objective To investigate the characteristic changes of high-order aberration (HOA) after different corneal refractive surgeries.Methods120 cases of patients with 236-eyes myopia and myopic astigmatism admitted into our hospital from June 2015 to December 2015, including 37 cases of 73-eyes received LASIK (A group), 40 cases of 78-eyes received FS-LASIK (B group), 43 cases of 85-eyes received FLEx (C group), compared 1 mo of cornea of HOA before and after surgeries of three groups.Results Comparing HOA of three groups before and after surgeries, there was statistical signiifcance (P<0.05), The vertical coma aberration of A and B groups, compared with that of C group, there was statistical significance (P<0.05).Conclusion HOA is increased signiifcantly after different corneal refractive surgeries, but FLEx surgery does not show obvious advantage because of the inlfuence of incision.%目的:探究不同角膜屈光手术后高阶像差(HOA)的特征性变化。方法选取我院2015年6~12月收治的120例236眼近视及近视散光患者,其中行LASIK(准分子激光原位角膜磨镶术)37例73眼(A组),行FS-LASIK(飞秒激光制瓣的LASIK)40例78眼(B组)B组,行FLEx(全飞秒激光FLEx)43例85眼(C组),对比三组手术前后1mo的角膜HOA。结果手术前后三组HOA相比,差异有统计学意义(P<0.05);A、B两组与C组相比,差异有统计意义(P<0.05)。结论不同角膜屈光手术后HOA均明显增加,而FLEx术因切口影响,未表现出明显优势。

  9. Clopidogrel and bleeding after general surgery procedures.

    Science.gov (United States)

    Ozao-Choy, Junko; Tammaro, Yolanda; Fradis, Martin; Weber, Kaare; Divino, Celia M

    2008-08-01

    Although many studies in the cardiothoracic literature exist about the relationship between clopidogrel and postoperative bleeding, there is scarce data in the general surgery literature. We assessed whether there are increased bleeding complications, morbidity, mortality, and resource utilization in patients who are on clopidogrel (Plavix) within 1 week before undergoing a general surgery procedure. Fifty consecutive patient charts were retrospectively reviewed after identifying patients who had pharmacy orders for clopidogrel and who underwent a general surgery procedure between 2003 and 2007. Patients who took clopidogrel within 6 days before surgery (group I, n = 28) were compared with patients who stopped clopidogrel for 7 days or more (group II, n = 22). A larger percentage of patients who took their last dose of clopidogrel within 1 week of surgery (21.4% vs 9.5%) had significant bleeding after surgery requiring blood transfusion. However, there were no significant differences between the groups in operative or postoperative blood transfusions (P = 0.12, 0.53), decreases in hematocrit (P = 0.21), hospital stay (P = 0.09), intensive care unit stay (P = 0.41), late complications (P = 0.45), or mortality (P = 0.42). Although our cohort is limited in size, these results suggest that in the case of a nonelective general surgery procedure where outcomes depend on timely surgery, clopidogrel taken within 6 days before surgery should not be a reason to delay surgery. However, careful attention must be paid to meticulous hemostasis, and platelets must be readily available for transfusion in the operating room.

  10. Nose Surgery

    Science.gov (United States)

    ... Patient Health Home Copyright © 2017 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly ... Terms of Use © Copyright 2017. American Academy of Otolaryngology — Head and Neck Surgery 1650 Diagonal Rd Alexandria, ...

  11. After Surgery

    Science.gov (United States)

    ... side effects. There is usually some pain with surgery. There may also be swelling and soreness around ... the first few days, weeks, or months after surgery. Some other questions to ask are How long ...

  12. Comparative evaluation of two different loading doses of dexmedetomidine with midazolam-fentanyl for sedation in vitreoretinal surgery under peribulbar anaesthesia

    OpenAIRE

    2016-01-01

    Background and Aims: Midazolam-fentanyl (MDZ:FEN) combination has been routinely used for intravenous sedation in ophthalmic surgeries. Dexmedetomidine (DEX), a recent α2 adrenoreceptor agonist indicated for sedation for ophthalmic use at a loading dose of 0.5 μg/kg over 10 min, can cause deeper plane of sedation and surgeon dissatisfaction. Therefore, we proposed to evaluate the efficacy and safety of two different loading doses of DEX. Methods: In a prospective study, 60 patients aged 50-70...

  13. Complications of strabismus surgery

    Directory of Open Access Journals (Sweden)

    Scott E Olitsky

    2015-01-01

    Full Text Available All surgeries carry risks of complications, and there is no way to avoid ever having a complication. Strabismus surgery is no different in this regard. There are methods to reduce the risk of a complication during or after surgery, and these steps should always be taken. When a complication occurs, it is important to first recognize it and then manage it appropriately to allow for the best outcome possible. This article will discuss some of the more common and/or most devastating complications that can occur during or after strabismus surgery as well as thoughts on how to avoid them and manage them should they happen.

  14. 小细胞肺癌术后放疗的临床意义分析%Clinical Significance of Postoperative Radiotherapy in the Treatment of Small Cell Lung Canger after Surgery

    Institute of Scientific and Technical Information of China (English)

    巩琳琳; 赵路军; 李瑞健; 曲晨慧; 王平

    2011-01-01

    Objective: To evaluate the role of post-operative radiotherapy ( PORT ) in the treatment of stage Ⅰ-Ⅲ small cell lung cancer ( SCLC ) after surgery, as well as to study the indication of PORT in patients with stage [-333 SCLC. Methods: Patients with stage Ⅰ-Ⅲ SCLC treated with surgery in Tianjin Medical University Cancer Institute and Hopital between January 1998 and December 2009 were retrospectively analyzed, and the effect of PORT on their prognosis was evaluated. Out of the eligible 98 patients, 39 patients had pathological stage No disease, 22 had N1 disease, and 37 had N2 disease. As to the treatment, 8 patients underwent surgery, 41 patients underwent pre-operative chemotherapy, 86 received post-operative chemotherapy, and 39 of patients received post-operative radiotherapy. Kaplan-Meier and Cox regression model were used to analyze the role of PORT. Results: The median survival for the whole group was 34 months, and the 3-year overall survival ( OS ) was 45.8%. Both the univariate and multivariate analyses showed that PORT did not significantly improve lite overall survival, but significantly reduced local-regional recurrence. The 3-year OS for lite PORT and non-PORT group were 49.7% and 39.3%, and me median survival were 36 months and 30 months, respectively ( P = 0.260 ). The 3-year local-regional recurrence rate were 7.7% and 28.8%, respectively (P= 0.001 ). The 3-year OS for pNO patients with and without PORT were 54.5% and 64.3%, respectively ( P - 0.705 ), were 53.8% and 33.3% for pN1 patients ( P - 0.067 ), and 46.7% and 22.7% ( P=0.141 ) for pN2 patients. Conclusion: PORT could reduce the local-regional recurrence of SCLC significantly, as well as the improvement of the overall survival rate of lymph node positive patients. Moreover, PORT may be considered for patients that still have lymph node positive SCLC after surgery.%目的:分析术后放疗在Ⅰ~Ⅲ期小细胞肺癌患者综合治疗中的地位.方法:回顾性分析2000年2

  15. Histologic effects of different technologies for dissection in endoscopic surgery: Nd:YAG laser, high frequency and water-jet.

    Science.gov (United States)

    Schurr, M O; Wehrmann, M; Kunert, W; Melzer, A; Lirici, M M; Trapp, R; Kanehira, E; Buess, G

    1994-01-01

    Precise cutting combined with reliable coagulation of the margins of the lesion is an important requirement for dissection techniques in endoscopic surgery. These requirements are met by the two most common ancillary energy sources applied for endoscopic dissection today, electrosurgery and "thermal lasers", mostly the Nd:YAG. For the comparison of the histological effects of monopolar and bipolar high frequency with the Nd:YAG laser an experimental in vitro and in vivo study has been performed. In order to evaluate the advantages of non thermal dissection for endoscopic procedures, a water jet cutting system was included in the in vitro study. In parenchymatous tissue the water jet was found to be the least traumatic technique, followed by bipolar high frequency, laser and monopolar high frequency. The water jet was not applicable for intestinal dissection since uncontrolled bloating of the rectal wall with uncontrolled disruption of the tissue layers occurred. A general disadvantage is that secure haemostasis in the line of incision is hard to achieve. In the microscopic comparison of the shape of the incision, the Nd:YAG laser produced the smoothest lesions with well-defined margins. The monopolar technique was more often associated with irregular and sometimes fissured margins. These results were confirmed in the in vivo part of the study (Transanal Endoscopic Microsurgery).

  16. Does primary brachial plexus surgery alter palliative tendon transfer surgery outcomes in children with obstetric paralysis?

    Directory of Open Access Journals (Sweden)

    Özkan Safiye

    2011-04-01

    Full Text Available Abstract Background The surgical management of obstetrical brachial plexus palsy can generally be divided into two groups; early reconstructions in which the plexus or affected nerves are addressed and late or palliative reconstructions in which the residual deformities are addressed. Tendon transfers are the mainstay of palliative surgery. Occasionally, surgeons are required to utilise already denervated and subsequently reinnervated muscles as motors. This study aimed to compare the outcomes of tendon transfers for residual shoulder dysfunction in patients who had undergone early nerve surgery to the outcomes in patients who had not. Methods A total of 91 patients with obstetric paralysis-related shoulder abduction and external rotation deficits who underwent a modified Hoffer transfer of the latissimus dorsi/teres major to the greater tubercle of the humerus tendon between 2002 and 2009 were retrospectively analysed. The patients who had undergone neural surgery during infancy were compared to those who had not in terms of their preoperative and postoperative shoulder abduction and external rotation active ranges of motion. Results In the early surgery groups, only the postoperative external rotation angles showed statistically significant differences (25 degrees and 75 degrees for total and upper type palsies, respectively. Within the palliative surgery-only groups, there were no significant differences between the preoperative and postoperative abduction and external rotation angles. The significant differences between the early surgery groups and the palliative surgery groups with total palsy during the preoperative period diminished postoperatively (p 0.05, respectively for abduction but not for external rotation. Within the upper type palsy groups, there were no significant differences between the preoperative and postoperative abduction and external rotation angles. Conclusions In this study, it was found that in patients with total

  17. 不同单肺通气方式在胸科手术中的分析%Different ways of single lung ventilation in the analysis of the thoracic surgery

    Institute of Scientific and Technical Information of China (English)

    张援; 廖婧华

    2015-01-01

    目的 比较支气管封堵器和双腔支气管导管在胸科手术中的应用.方法 择期胸科手术患者100例,随机分为A组(支气管封堵器)和B组(双腔支气管导管).比较两组的插管时间、定位时间、术野暴露程度及术后咽喉痛的发生率.结果 A组的插管时间和术后咽喉痛发生率均明显低于B组(P<0.05),两组在定位时间和术野暴露程度上的差异无统计学意义.结论 支气管封堵器具有插管容易耗时短、术后咽喉痛发生率低等优势,在胸科手术中可以加以推广.%Objective compare bronchial occluder and double cavity bronchial catheter application in thoracic surgery. methods 100 patients with elective thoracic surgery were randomly divided into group A (bronchial occluder) and group B (double cavity bronchial tube). Comparison of two groups of intubation time, location, the operative field exposure and the incidence of postoperative sore throat.Results group A intubation time and the incidence of postoperative sore throat were significantly lower than that of group B (P < 0.05), two groups in the positioning time and operative field exposure difference in degree has no statistical significance. Conclusion bronchial occluder has easy intubation time, low incidence of postoperative sore throat advantages, can promote in the thoracic surgery.

  18. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment of jaws and ... Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, and is best performed by ...

  19. Body image and quality of life in patients with and without body contouring surgery following bariatric surgery: a comparison of pre- and post-surgery groups

    Science.gov (United States)

    de Zwaan, Martina; Georgiadou, Ekaterini; Stroh, Christine E.; Teufel, Martin; Köhler, Hinrich; Tengler, Maxi; Müller, Astrid

    2014-01-01

    Background: Massive weight loss (MWL) following bariatric surgery frequently results in an excess of overstretched skin causing physical discomfort and negatively affecting quality of life, self-esteem, body image, and physical functioning. Methods: In this cross-sectional study 3 groups were compared: (1) patients prior to bariatric surgery (n = 79), (2) patients after bariatric surgery who had not undergone body contouring surgery (BCS) (n = 252), and (3) patients after bariatric surgery who underwent subsequent BCS (n = 62). All participants completed self-report questionnaires assessing body image (Multidimensional Body-Self Relations Questionnaire, MBSRQ), quality of life (IWQOL-Lite), symptoms of depression (PHQ-9), and anxiety (GAD-7). Results: Overall, 62 patients (19.2%) reported having undergone a total of 90 BCS procedures. The most common were abdominoplasties (88.7%), thigh lifts (24.2%), and breast lifts (16.1%). Post-bariatric surgery patients differed significantly in most variables from pre-bariatric surgery patients. Although there were fewer differences between patients with and without BCS, patients after BCS reported better appearance evaluation (AE), body area satisfaction (BAS), and physical functioning, even after controlling for excess weight loss and time since surgery. No differences were found for symptoms of depression and anxiety, and most other quality of life and body image domains. Discussion: Our results support the results of longitudinal studies demonstrating significant improvements in different aspects of body image, quality of life, and general psychopathology after bariatric surgery. Also, we found better AE and physical functioning in patients after BCS following bariatric surgery compared to patients with MWL after bariatric surgery who did not undergo BCS. Overall, there appears to be an effect of BCS on certain aspects of body image and quality of life but not on psychological aspects on the whole. PMID:25477839

  20. Body image and quality of life in patients with and without body contouring surgery following bariatric surgery: a comparison of pre- and post-surgery groups

    Directory of Open Access Journals (Sweden)

    Martina eDe Zwaan

    2014-11-01

    Full Text Available Background: Massive weight loss (MWL following bariatric surgery frequently results in an excess of overstretched skin causing physical discomfort and negatively affecting quality of life, self-esteem, body image and physical functioning.Methods: In this cross-sectional study 3 groups were compared: 1 patients prior to bariatric surgery (n=79, 2 patients after bariatric surgery who had not undergone BCS (n=252, and 3 patients after bariatric surgery who underwent subsequent body contouring surgery (BCS (n=62. All participants completed self-report questionnaires assessing body image (MBSRQ, quality of life (IWQOL-Lite, symptoms of depression (PHQ-9 and anxiety (GAD-7.Results: Overall, 62 patients (19.2% reported having undergone a total of 90 BCS procedures. The most common were abdominoplasties (88.7%, thigh lifts (24.2%, and breast lifts (16.1%. Post-bariatric surgery patients differed significantly in most variables from pre-bariatric surgery patients; however, there were fewer differences between patients with and without BCS. Patients after BCS reported better appearance evaluation, body area satisfaction, and physical functioning, even after controlling for excess weight loss and time since surgery. No differences were found for symptoms of depression and anxiety, and most other quality of life and body image domains. Discussion: Our results support the results of longitudinal studies demonstrating significant improvements in different aspects of body image, quality of life, and general psychopathology after bariatric surgery. Also, we found better appearance evaluation and physical functioning in patients after BCS following bariatric surgery compared to patients with MWL after bariatric surgery who did not undergo BCS. Overall, there appears to be an effect of BCS on certain aspects of body image and quality of life but not on psychological aspects on the whole.

  1. Review on different experimental techniques developed for recording force-deformation behaviour of soft tissues; with a view to surgery simulation applications.

    Science.gov (United States)

    Afshari, Elnaz; Rostami, Mostafa; Farahmand, Farzam

    2017-05-01

    Different experimental techniques which have been developed to obtain data related to force-deformation behaviour of soft tissues play an important role in realistically simulating surgery processes as well as medical diagnoses and minimally invasive procedures. Indeed, an adequate quantitative description of soft-tissue-mechanical-behaviour requires high-quality experimental data to be obtained and analysed. In this review article we will first scan the motivations and basic technical issues on surgery simulation. Then, we will concentrate on different experimental techniques developed for recording force-deformation (stress-strain) behaviour of soft tissues with focussing on the in-vivo experimental setups. We will thoroughly review the available techniques by classifying them to four groups; elastography, indentation, aspiration and grasping techniques. The evolutions, advantages and limitations of each technique will be presented by a historical review. At the end, a discussion is given with the aim of summarising the proposed points and predicting the future of techniques utilised in extracting data related to force-deformation behaviour.

  2. Minnesota multiphasic personality inventory-2 restructured form (MMPI-2-RF) scale score differences in bariatric surgery candidates diagnosed with binge eating disorder versus BMI-matched controls.

    Science.gov (United States)

    Marek, Ryan J; Ben-Porath, Yossef S; Ashton, Kathleen; Heinberg, Leslie J

    2014-04-01

    Binge Eating Disorder (BED) is among the most common psychiatric disorders in bariatric surgery candidates. The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) is a broadband, psychological test that includes measures of emotional and behavioral dysfunction, which have been associated with BED behaviors in bariatric surgery candidates; however these studies have lacked appropriate controls. In the current study, we compared MMPI-2-RF scale scores of bariatric surgery patients diagnosed with BED (BED+) with BMI-matched controls without BED (BED-). Three-hundred and seven BED+ participants (72.64% female and 67.87% Caucasian; mean BMI of 51.36 kg/m(2) [SD = 11.94]) were drawn from a large, database (N = 1304). Three-hundred and seven BED- participants were matched on BMI and demographics (72.64% female, 68.63% Caucasian, and mean BMI of 51.30 kg/m(2) [SD = 11.70]). The BED+ group scored significantly higher on measures of Demoralization, Low Positive Emotions, and Dysfunctional Negative Emotions and scored lower on measures of Antisocial Behaviors, reflecting behavioral constraint. Optimal T-Score cutoffs were below the traditional 65 T score for several MMPI-2-RF scales. MMPI-2-RF externalizing measures also added incrementally to differentiating between the groups beyond the Binge Eating Scale (BES). BED+ individuals produced greater elevations on a number of MMPI-2-RF internalizing scales and externalizing scales. Use of the test in conjunction with a clinical interview and other self-report data can further aid the clinician in guiding patients to appropriate treatment to optimize outcome. Copyright © 2013 Wiley Periodicals, Inc.

  3. Promoting ossification of calvarial defects in craniosynostosis surgery by demineralized bone plate and bone dust in different age groups.

    Science.gov (United States)

    Savolainen, M; Ritvanen, A; Hukki, J; Vuola, P; Telkkä, J; Leikola, J

    2017-01-01

    Correction of calvarial defects after calvarial vault reconstruction (CVR) is challenging in craniosynostosis patients of advanced age and typically employs autologous bone. Demineralized bone matrix (DBM) is a potential alternative material for autologous bone, but its use has not been extended to correct calvarial defects. CVR patients operated at the Department of Plastic Surgery, Helsinki University Hospital, during 2008-2010 were retrospectively reviewed. Inclusion criteria of the study were CVR patients who received DBM plate, with or without bone dust, on calvarial defects and who had suitable uncovered defect on the contralateral side as control. This study included 17 craniosynostosis and one positional plagiocephaly patient, whose mean age was 6.9 years (range 0.9-19 years). The mean follow-up time was 5.6 years. The fusion degree of all defects was measured from 1 week to 1 year postoperatively using three-dimensional computed tomography (3D CT) images by the OsiriX(©) method. Medical records were reviewed for DBM-related complications. A total of 26 defects were covered with a DBM plate (mean area 11.1 cm(2)) and 26 control defects were identified (mean area 7.8 cm(2)). The mean fusion degree of the DBM defects was 74% and 54% for the controls (p plate is a safe and useful material to promote ossification in calvarial defects in CVR. Furthermore, DBM appears to be more effective in older patients (>30 months) than in younger patients or when used with bone dust. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  4. Diabetes surgery in type 2 BMI 24-29 vs IMC 30-34 diabetic patients: is there differences among restrictive, malabsorptive and gastric bypass procedures?

    Science.gov (United States)

    Garciacaballero, M; Navarrete, S; Favretti, F; Celik, A; Del Castillo, D

    2013-03-01

    Diabetes mellitus (DM) is a public health problem with a prevalence of 345 million people worldwide that it may double by the year 2030 and have a high costs and mortality. Gastrointestinal surgery is accepted as a form of treatment that was already suggested for obese in 1987 by Pories, confirmed for obese patients by the metaanalysis of Buchwald and the direct comparison of gastric bypass with medical treatment in the study of Schauer that demonstrate a 4 fold greater resolution rate of DM with surgery. Improvement occurs immediately after surgery, before the patients lose weight in with BMI > 35; but there is doubt if the existent evidence is enough to extrapolate these results to patients with BMI < 35 and especially with BMI < 30, in spite that four reviews in patients with this BMI and DM2 demonstrated the same results when stomach, duodenum and part of jejunum is bypassed as happen gastric bypass (better results with this of one anastomosis than of two anastomosis, Roux-en-Y) BPD. For patients with a BMI between 30 and 35 restrictive techniques: LAGB and SGL are good but not better than the mixed: RYGB, BAGUA, or SG-DJB with remission from 60 to 100%, minor in the derivative: BPD and above on the IID with a 81% of remission. There are no differences in the metabolic control in comparison to the obese, It is progressively better with DJB, SDS, IID and BAGUA especially in patients who do not require insulin, have less time with disease, have normal C peptide levels, and not so much relation with the initial BMI that is only important to decide the degree of restriction. Although several mechanisms has been suggested for explaining these results such as caloric intake, hormonal changes, bypass of the anterior or early stimulation of posterior intestine, fundectomy, intestinal gluconeogenesis and others, new ones will appear in the near future.

  5. Diabetes surgery in type 2 BMI 24-29 vs IMC 30-34 diabetic patients: is there differences among restrictive, malabsorptive and gastric bypass procedures?

    Directory of Open Access Journals (Sweden)

    M. Garciacaballero

    Full Text Available Diabetes mellitus (DM is a public health problem with a prevalence of 345 million people worldwide that it may double by the year 2030 and have a high costs and mortality. Gastrointestinal surgery is accepted as a form of treatment that was already suggested for obese in 1987 by Pories, confirmed for obese patients by the meta-analysis of Buchwald and the direct comparison of gastric bypass with medical treatment in the study of Schauer that demonstrate a 4 fold greater resolution rate of DM with surgery. Improvement occurs immediately after surgery, before the patients lose weight in with BMI > 35; but there is doubt if the existent evidence is enough to extrapolate these results to patients with BMI < 35 and especially with BMI < 30, in spite that four reviews in patients with this BMI and DM2 demonstrated the same results when stomach, duodenum and part of jejunum is bypassed as happen gastric bypass (better results with this of one anastomosis than of two anastomosis, Rouxen-Y BPD. For patients with a BMI between 30 and 35 restrictive techniques: LAGB and SGL are good but not better than the mixed: RYGB, BAGUA, or SG-DJB with remission from 60 to 100%, minor in the derivative: BPD and above on the IID with a 81% of remission. There are no differences in the metabolic control in comparison to the obese, It is progressively better with DJB, SDS, IID and BAGUA especially in patients who do not require insulin, have less time with disease, have normal C peptide levels, and not so much relation with the initial BMI that is only important to decide the degree of restriction. Although several mechanisms has been suggesed for explaining these results such as caloric intake, hormonal changes, bypass of the anterior or early stimulation of posterior intestine, fundectomy, intestinal gluconeogenesis and others, new ones will appear in the near future.

  6. Influence of coefficient of variation in determining significant difference of quantitative values obtained from 28-day repeated-dose toxicity studies in rats.

    Science.gov (United States)

    Kobayashi, Katsumi; Sakuratani, Yuki; Abe, Takemaru; Yamazaki, Kazuko; Nishikawa, Satoshi; Yamada, Jun; Hirose, Akihiko; Kamata, Eiichi; Hayashi, Makoto

    2011-01-01

    In order to understand the influence of coefficient of variation (CV) in determining significant difference of quantitative values of 28-day repeated-dose toxicity studies, we examined 59 parameters of 153 studies conducted in accordance with Chemical Substance Control Law in 12 test facilities. Sex difference was observed in 12 parameters and 10 parameters showed large CV in females. The minimum CV was 0.74% for sodium. CV of electrolytes was comparatively small, whereas enzymes had large CV. Large differences in CV were observed for major parameters among 7-8 test facilities. The changes in CV were grossly classified into 11. Our study revealed that a statistical significant difference is usually detected if there is a difference of 7% in mean values between the groups and the groups have a CV of about 7%. A parameter with a CV as high as 30% may be significantly different, if the difference of the mean between the groups is 30%. It would be ideal to use median value to assess the treatment-related effect, rather than mean, when the CV is very high. We recommend using CV of the body weight as a standard to judge the adverse effect level.

  7. DARHUBER: A Computer Program for Effect Size Estimation in Linear Regression and for Calculating the Significance of Difference between Observed and Expected R2 Values

    OpenAIRE

    Hittner, James B.; N. Clayton Silver

    2016-01-01

    In linear multiple regression it is common practice to test whether the squared multiple correlation co efficient, R2, differs significantly from zero. Although frequently used, this test is misleading because the expected value of R2 is not zero under the null hypothesis that ρ, the population value of the multiple correlation coefficient, equals zero. The non-zero expected value of R2 has implications both for significance testing and effect size estimation involving the squared multipl...

  8. Methods of patient warming during abdominal surgery.

    Directory of Open Access Journals (Sweden)

    Li Shao

    Full Text Available BACKGROUND: Keeping abdominal surgery patients warm is common and warming methods are needed in power outages during natural disasters. We aimed to evaluate the efficacy of low-cost, low-power warming methods for maintaining normothermia in abdominal surgery patients. METHODS: Patients (n = 160 scheduled for elective abdominal surgery were included in this prospective clinical study. Five warming methods were applied: heated blood transfusion/fluid infusion vs. unheated; wrapping patients vs. not wrapping; applying moist dressings, heated or not; surgical field rinse heated or not; and applying heating blankets or not. Patients' nasopharyngeal and rectal temperatures were recorded to evaluate warming efficacy. Significant differences were found in mean temperatures of warmed patients compared to those not warmed. RESULTS: When we compared temperatures of abdominal surgery patient groups receiving three specific warming methods with temperatures of control groups not receiving these methods, significant differences were revealed in temperatures maintained during the surgeries between the warmed groups and controls. DISCUSSION: The value of maintaining normothermia in patients undergoing abdominal surgery under general anesthesia is accepted. Three effective economical and practically applicable warming methods are combined body wrapping and heating blanket; combined body wrapping, heated moist dressings, and heating blanket; combined body wrapping, heated moist dressings, and warmed surgical rinse fluid, with or without heating blanket. These methods are practically applicable when low-cost method is indeed needed.

  9. Patient-specific positioning guides for total knee arthroplasty: no significant difference between final component alignment and pre-operative digital plan except for tibial rotation

    OpenAIRE

    Boonen, Bert; Schotanus, Martijn G.M.; Kerens, Bart; Hulsmans, Frans-Jan; Tuinebreijer, Wim; Kort, Nanne P.

    2015-01-01

    Purpose To assess whether there is a significant difference between the alignment of the individual femoral and tibial components (in the frontal, sagittal and horizontal planes) as calculated pre-operatively (digital plan) and the actually achieved alignment in vivo obtained with the use of patient-specific positioning guides (PSPGs) for TKA. It was hypothesised that there would be no difference between post-op implant position and pre-op digital plan. Methods Twenty-six patients were includ...

  10. Evidence of uneven selective pressure on different subsets of the conserved human genome; implications for the significance of intronic and intergenic DNA

    Directory of Open Access Journals (Sweden)

    MacKenzie Alasdair

    2009-12-01

    Full Text Available Abstract Background Human genetic variation produces the wide range of phenotypic differences that make us individual. However, little is known about the distribution of variation in the most conserved functional regions of the human genome. We examined whether different subsets of the conserved human genome have been subjected to similar levels of selective constraint within the human population. We used set theory and high performance computing to carry out an analysis of the density of Single Nucleotide Polymorphisms (SNPs within the evolutionary conserved human genome, at three different selective stringencies, intersected with exonic, intronic and intergenic coordinates. Results We demonstrate that SNP density across the genome is significantly reduced in conserved human sequences. Unexpectedly, we further demonstrate that, despite being conserved to the same degree, SNP density differs significantly between conserved subsets. Thus, both the conserved exonic and intronic genomes contain a significantly reduced density of SNPs compared to the conserved intergenic component. Furthermore the intronic and exonic subsets contain almost identical densities of SNPs indicating that they have been constrained to the same degree. Conclusion Our findings suggest the presence of a selective linkage between the exonic and intronic subsets and ascribes increased significance to the role of introns in human health. In addition, the identification of increased plasticity within the conserved intergenic subset suggests an important role for this subset in the adaptation and diversification of the human population.

  11. Effect and its clinical significance of different dose of glucocorticoids on inflammation mediators in patients with acute exacerbation of chronic obstructive pulmonary diseases

    Institute of Scientific and Technical Information of China (English)

    钟佰强

    2014-01-01

    Objective To explore the effect and its clinical significance of different dose of glucocorticoids on inflammation mediators in patients with acute exacerbation of chronic obstructive pulmonary diseases.Methods 45 patients admitted to our hospitals from March 2007 to March 2011were randomly divided into 3 groups:methylprednisolone40 mg group(methylprednisolone 40mg,iv,qd),meth-

  12. Quality of Life for Individuals with Hearing Impairment Who Have Not Consulted for Services and Their Significant Others: Same- and Different-Sex Couples

    Science.gov (United States)

    Kelly, Rebecca J.; Atcherson, Samuel R.

    2011-01-01

    The purpose of this exploratory study was to assess perceptions of quality of life for individuals with hearing impairment who have not consulted for services and their significant others who are in same-sex relationships vs. those who are in different-sex relationships. Data were collected on a total of 20 older couples: 10 in same-sex…

  13. Minimally invasive surgery for esophageal cancer.

    Science.gov (United States)

    Santillan, Alfredo A; Farma, Jeffrey M; Meredith, Kenneth L; Shah, Nilay R; Kelley, Scott T

    2008-10-01

    Esophageal cancer represents a major public health problem worldwide. Several minimally invasive esophagectomy (MIE) techniques have been described and represent a safe alternative for the surgical management of esophageal cancer in selected centers with high volume and expertise in them. This article reviews the most recent and largest series evaluating MIE techniques. Recent larger series have shown MIE to be equivalent in postoperative morbidity and mortality rates to conventional surgery. MIE has been associated with less blood loss, less postoperative pain, and decreased intensive care unit and hospital length of stay compared with conventional surgery. Despite limited data, conventional surgery and MIE have shown no significant difference in survival, stage for stage. The myriad of MIE techniques complicates the debate of defining the optimal surgical approach for treating esophageal cancer. Randomized controlled trials comparing MIE with conventional open esophagectomy are needed to clarify the ideal procedure with the lowest postoperative morbidity, best quality of life after surgery, and long-term survival.

  14. Laparoscopic surgery for early endometrial cancer

    DEFF Research Database (Denmark)

    Bennich, Gitte; Rudnicki, M.; Lassen, P. D.

    2016-01-01

    IntroductionThe purpose of the present study was to evaluate learning curves and short-term outcomes following laparoscopic surgery for early endometrial cancer in women of different body mass index (BMI) classes. Material and methodsData from 227 women planned for laparoscopic surgery for presumed...... stage I endometrial cancer were collected retrospectively from a Danish gynecologic oncology unit. Surgery included laparoscopic hysterectomy and bilateral salpingo-oophorectomy with or without pelvic lymphadenectomy (PLA). ResultsMedian length of operations was 60 min (range, 30-197) and 120 min (range...... peri- and postoperative outcomes were independent of BMI classes. ConclusionsOur data suggest that laparoscopic surgery for early endometrial cancer is feasible and safe. With increasing surgeon's experience there is a significant decrease in operative time and increase in the number of lymph nodes...

  15. Biomechanical Evaluation of Different Fixation Methods for Mandibular Anterior Segmental Osteotomy Using Finite Element Analysis, Part One: Superior Repositioning Surgery.

    Science.gov (United States)

    Kilinç, Yeliz; Erkmen, Erkan; Kurt, Ahmet

    2016-01-01

    The aim of the current study was to comparatively evaluate the mechanical behavior of 3 different fixation methods following various amounts of superior repositioning of mandibular anterior segment. In this study, 3 different rigid fixation configurations comprising double right L, double left L, or double I miniplates with monocortical screws were compared under vertical, horizontal, and oblique load conditions by means of finite element analysis. A three-dimensional finite element model of a fully dentate mandible was generated. A 3 and 5 mm superior repositioning of mandibular anterior segmental osteotomy were simulated. Three different finite element models corresponding to different fixation configurations were created for each superior repositioning. The von Mises stress values on fixation appliances and principal maximum stresses (Pmax) on bony structures were predicted by finite element analysis. The results have demonstrated that double right L configuration provides better stability with less stress fields in comparison with other fixation configurations used in this study.

  16. Age- and Gender-related Differences in the Use of Secondary Medical Prevention after Primary Vascular Surgery

    DEFF Research Database (Denmark)

    Høgh, Annette Langager; Lindholt, Jes S.; Nielsen, Henrik

    2012-01-01

    This study examined the possible age- and gender-related differences in the use of secondary medical prevention following primary vascular reconstruction in a population-based long-term follow-up study.......This study examined the possible age- and gender-related differences in the use of secondary medical prevention following primary vascular reconstruction in a population-based long-term follow-up study....

  17. Endodontic surgery.

    Science.gov (United States)

    Chong, B S; Rhodes, J S

    2014-03-01

    A better understanding of endodontic disease and the causes of treatment failure has refined the role of surgery in endodontics. The advent of newer materials, advances in surgical armamentarium and techniques have also led to an improved endodontic surgical outcome. The aim of this article is to provide a contemporary and up-to-date overview of endodontic surgery. It will focus primarily on the procedures most commonly performed in endodontic surgery.

  18. The evaluation of effects two different doses of hydrocortisone on the intensity of perioperative shivering in elective surgery under spinal anesthesia: A double-blind randomized controlled trial study

    Directory of Open Access Journals (Sweden)

    Mohammadreza Safavi

    2016-01-01

    Full Text Available Background: Post- and intra-operative shivering is one of the most complications of spinal anesthesia so recommend a suitable drug with at least complications for prevention and control of postoperative shivering. This current study aimed to compare the preventive effect of hydrocortisone on intra- and post-operative shivering in patients undergoing surgery with spinal anesthesia. Materials and Methods: In a clinical trial study, ninety patients who candidate for surgery with spinal anesthesia were selected and randomly divided into three groups. The first and second groups were received 1 mg/kg and 2 mg/kg hydrocortisone, respectively, and the third group was received normal saline, and postoperative shivering was compared between the three groups. Results: The investigation of the incidence of inter- and post-operative shivering in patients in the three groups revealed that within the study period, 31 patients suffered from shivering among which 9, 5, and 17 cases were in 1 mg/kg hydrocortisone group, 2 mg/kg hydrocortisone group, and placebo group, respectively, and according to the Chi-square test, the difference among the three groups was significant (P = 0.004. Conclusion: According to the obtained results, the overall conclusion of the study is that using hydrocortisone at least with the dose of 1 mg/kg as a preventive drug reduced the incidence of intra- and post-operative shivering with spinal anesthesia.

  19. Arterio-venous concentration difference of [51Cr]EDTA after a single injection in man. Significance of renal function and local blood flow

    DEFF Research Database (Denmark)

    Rehling, M; Hyldstrup, L; Henriksen, Jens Henrik Sahl

    1989-01-01

    The present investigation was undertaken in order to study (1) the difference in arterial (Ca) and venous (Cv) concentration of [51Cr]EDTA (ethylenediaminetetraacetate) after a single intravenous injection, (2) the impact of different physiological variables on this difference, and (3) the error......, and 180-300 min post-injection (p.i.) Cv was 5.9% higher than Ca (range 0.5-13.9%, P less than 0.001). The more reduced renal function, the smaller was the concentration difference. The areas under the arterial and the venous plasma concentration curves did not differ significantly at either 0-infinity...... or 0-300 min p.i. whereas the venous area 0-100 min p.i. underestimated the arterial area in the same period by 4.1% (P less than 0.05). In a computer simulation model, variation in the forearm capillary permeability-surface area product did not have any significant influence on the Cv-Ca difference...

  20. Reproducibility of atypia of undetermined significance/follicular lesion of undetermined significance category using the bethesda system for reporting thyroid cytology when reviewing slides from different institutions: A study of interobserver variability among cytopathologists.

    Science.gov (United States)

    Padmanabhan, Vijayalakshmi; Marshall, Carrie B; Akdas Barkan, Guliz; Ghofrani, Mohiedean; Laser, Alice; Tolgay Ocal, Idris; David Sturgis, Charles; Souers, Rhona; Kurtycz, Daniel F I

    2017-05-01

    The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) offers a six-tiered diagnostic scheme for thyroid Fine Needle Aspiration (FNA): Benign, Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance (AUS/FLUS), suspicious for follicular neoplasm, suspicious for malignancy, malignant, and unsatisfactory with an aim to standardize diagnostic criteria. Reported rate of AUS/FLUS category in the literature has varied from 3% to 20.5%. The aim of this study was to assess interobserver variability among cytopathologists to assess reproducibility of the AUS/FLUS category. Seven cytopathologists brought FNA cases (a mixture of atypical and non-atypical FNA diagnosis) diagnosed using TBSRTC from their respective institutions which were reviewed and diagnosed by the participants. The analysis assessed interobserver variability among 7 cytopathologists and determined characteristics on the slides which were associated with concordance to the institutional diagnosis. Seventy eight of 125 (62.4%) benign cases were classified as benign by the reviewers and 26 (21%) were called AUS/FLUS on review. A third of the AUS/FLUS cases were called benign on review and 28.2% were classified as suspicious for neoplasia/malignancy. Roughly a third each of the suspicious for follicular neoplasm/suspicious for malignancy cases were classified as AUS/FLUS. When pathologists from different institutions shared their slides, concordance was high for specimens with adequate cellularity and those that were clearly benign but thresholds varied for the other indeterminate categories. Most definite categorization of the AUS/FLUS category was seen on review. Diagn. Cytopathol. 2017;45:399-405. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  1. Diode laser surgery versus scalpel surgery in the treatment of fibrous hyperplasia: a randomized clinical trial.

    Science.gov (United States)

    Amaral, M B F; de Ávila, J M S; Abreu, M H G; Mesquita, R A

    2015-11-01

    Fibrous hyperplasia is treated by surgical incision using a scalpel, together with removal of the source of chronic trauma. However, scalpel techniques do not provide the haemostasis that is necessary when dealing with highly vascular tissues. Diode laser surgery can be used in the management of oral tissues due to its high absorption by water and haemoglobin, and has provided good results in both periodontal surgery and oral lesions. The aim of the present study was to compare the effects of diode laser surgery to those of the conventional technique in patients with fibrous hyperplasia. A randomized clinical trial was performed in which surgical and postoperative evaluations were analyzed. On comparison of the laser-treated (study group) patients to those treated with a scalpel (control group), significant differences were observed in the duration of surgery and the use of analgesic medications. Over a 3-week period, clinical healing of the postoperative wound was significantly faster in the control group as compared to the study group. In conclusion, diode laser surgery proved to be more effective and less invasive when compared to scalpel surgery in the management of fibrous hyperplasia. However, wound healing proved to be faster when using scalpel surgery.

  2. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Dental Implant Surgery Dental implant surgery is, of course, surgery, and is best performed by a trained ... Dental Implant Surgery Dental implant surgery is, of course, surgery, and is best performed by a trained ...

  3. Hemorrhage after transoral robotic-assisted surgery.

    Science.gov (United States)

    Asher, Scott A; White, Hilliary N; Kejner, Alexandra E; Rosenthal, Eben L; Carroll, William R; Magnuson, J Scott

    2013-07-01

    An increasing number of head and neck surgeons have begun using transoral robotic-assisted surgery. Our objective was to examine the postoperative bleeding complications we have encountered to determine risk factors and to discuss the topic of hemorrhage control. Case series with chart review. Medical records were reviewed in 147 consecutive patients undergoing transoral robotic-assisted surgery for any indication at one tertiary academic medical center between March 2007 and September 2011. Eleven of 147 (7.5%) patients undergoing transoral robotic-assisted surgery experienced some degree of postoperative hemorrhage, with 9 patients requiring reoperation for examination and/or control of bleeding. Bleeding occurred at a mean of 11.1 ± 9.2 days after initial operation. Eight of 11 (72%) patients who bled were on antithrombotic medication (anticoagulants or antiplatelet agents) for other medical comorbidities. The postoperative hemorrhage rate in patients taking antithrombotic medication (8/48 patients = 17%) was significantly higher than in those not taking antithrombotics (3/99 patients = 3%), P = .0057. While the bleeding rate in salvage surgery (3/29 = 10.3%) was slightly higher than in primary surgery (8/118 = 6.8%), this difference did not reach statistical significance. Potential for postoperative bleeding in association with antithrombotic medications in patients undergoing transoral robotic-assisted surgery should be recognized. Various effective techniques for management of these patients without robotic assistance were demonstrated.

  4. Thyroid Surgery

    Science.gov (United States)

    ... etc.). Surgery is also an option for the treatment of hyperthyroidism (Grave’s disease or a “toxic nodule” (see Hyperthyroidism brochure ), for large and multinodular goiters and for any goiter that may be causing ... MEANS OF TREATMENT? Surgery is definitely indicated to remove nodules suspicious ...

  5. Comparative assessment of physical and cognitive ergonomics associated with robotic and traditional laparoscopic surgeries.

    Science.gov (United States)

    Lee, Gyusung I; Lee, Mija R; Clanton, Tameka; Clanton, Tamera; Sutton, Erica; Park, Adrian E; Marohn, Michael R

    2014-02-01

    We conducted this study to investigate how physical and cognitive ergonomic workloads would differ between robotic and laparoscopic surgeries and whether any ergonomic differences would be related to surgeons' robotic surgery skill level. Our hypothesis is that the unique features in robotic surgery will demonstrate skill-related results both in substantially less physical and cognitive workload and uncompromised task performance. Thirteen MIS surgeons were recruited for this institutional review board-approved study and divided into three groups based on their robotic surgery experiences: laparoscopy experts with no robotic experience, novices with no or little robotic experience, and robotic experts. Each participant performed six surgical training tasks using traditional laparoscopy and robotic surgery. Physical workload was assessed by using surface electromyography from eight muscles (biceps, triceps, deltoid, trapezius, flexor carpi ulnaris, extensor digitorum, thenar compartment, and erector spinae). Mental workload assessment was conducted using the NASA-TLX. The cumulative muscular workload (CMW) from the biceps and the flexor carpi ulnaris with robotic surgery was significantly lower than with laparoscopy (p  0.05). Robotic surgery experts and novices had significantly higher performance scores with robotic surgery than with laparoscopy (p cognitive ergonomics with robotic surgery were significantly less challenging. Additionally, several ergonomic components were skill-related. Robotic experts could benefit the most from the ergonomic advantages in robotic surgery. These results emphasize the need for well-structured training and well-defined ergonomics guidelines to maximize the benefits utilizing the robotic surgery.

  6. Protection effects of Sigmart for no-reflow or myocardial reperfusion injury after undergoing PCI surgery

    Institute of Scientific and Technical Information of China (English)

    Xiao-Peng Wu; Xuan-Qi Wang; Lei-Sen Han; Chong-Zhen Wang; Yin-Juan Mao; Wei-Jie Li

    2015-01-01

    Objective:To study the protection effects of Sigmart for lack of reflow or myocardial myocardial reperfusion injury after undergoing PCI surgery.Methods: A total of 150 patients undergoing PCI surgery were selected and divided into control group and observation group with 75 cases in each group. After undergoing the surgery, both groups were given low molecular heparin 4 100 IU for 3 d, 100 mg + aspirin + atorvastatin 20 mg + clopidogrel 75 mg. 5 mL of blood specimen were collected for detection of troponin I (TnI), myocardial enzyme spectrum (CK, CK-MB) level to evaluate myocardial myocardial reperfusion injury after undergoing PCI surgery. Also electrocardiogram (ECG) were detected. Six months after the surgery, effects of Sigmart for lack of reflow or myocardial myocardial reperfusion injury after undergoing PCI surgery were evaluated.Results: 1, 6, 12, 24 h after the surgery, TnI, Mb, CK-Mb levels of were significant different from those before undergoing the surgery, and these levels of the observation group were significant higher than that of the control group. ST segment elevation at 2, 12, and 24 h after undergoing the surgery were significant obvious than that of the control group. According to the follow up, incidence of comprehensive end point event was significant higher than that of the control group. SAQ and SF-36 scores of the two groups were significant different. Conclusion: Sigmart shows good protection effects for lack of reflow or myocardial myocardial reperfusion injury after undergoing PCI surgery.

  7. Choosing surgery

    DEFF Research Database (Denmark)

    Thorstensson, Carina; Lohmander, L; Frobell, Richard

    2009-01-01

    ABSTRACT: BACKGROUND: The objective was to understand patients' views of treatment after acute anterior cruciate ligament (ACL) injury, and their reasons for deciding to request surgery despite consenting to participate in a randomised controlled trial (to 'cross-over'). METHODS: Thirty-four in......-depth qualitative interviews were conducted with young (aged 18-35), physically active individuals with ACL rupture who were participating in a RCT comparing training and surgical reconstruction with training only. 22/34 were randomised to training only but crossed over to surgery. Of these, 11 were interviewed...... before surgery, and 11 were interviewed at least 6 months after surgery. To provide additional information, 12 patients were interviewed before randomisation. Interviews were audio-recorded, transcribed and analysed using the Framework approach. RESULTS: Strong preference for surgery was commonplace...

  8. Randomised control trial showed that delayed cord clamping and milking resulted in no significant differences in iron stores and physical growth parameters at one year of age.

    Science.gov (United States)

    Agarwal, Shivam; Jaiswal, Vijay; Singh, Dharamveer; Jaiswal, Prateek; Garg, Amit; Upadhyay, Amit

    2016-11-01

    Placental redistribution has been shown to improve haematological outcomes in the immediate neonatal period and early infancy. This study compared the effects of delayed cord clamping (DCC) and umbilical cord milking (UCM) on haematological and growth parameters at 12 months of age. This was a follow-up study of a randomised control trial, conducted in a tertiary care paediatric centre from August 2013 to August 2014. We studied 200 apparently healthy Indian infants randomised at birth to receive DCC for 60-90 seconds or UCM. The outcome measures were iron status and physical growth parameters at 12 months. Of the 200 babies, 161 completed the follow-up and baseline characteristics were comparable in both groups. The mean haemoglobin in the DCC group (102.2 (17.2) g/L and serum ferritin 16.44 (2.77) μg/L) showed no significant differences to the UCM group (98.6 (17.1) g/L and 18.2 (2.8) μg/L) at one year. In addition, there were no significant differences in weight, height and mid-upper arm circumference in the two groups. Term-born Indian infants who had DCC at 60-90 seconds or UCM showed no significant differences in ferritin and haemoglobin levels and growth parameters at 12 months of age. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  9. Reversal of apixaban induced alterations in hemostasis by different coagulation factor concentrates: significance of studies in vitro with circulating human blood.

    Directory of Open Access Journals (Sweden)

    Gines Escolar

    Full Text Available Apixaban is a new oral anticoagulant with a specific inhibitory action on FXa. No information is available on the reversal of the antihemostatic action of apixaban in experimental or clinical settings. We have evaluated the effectiveness of different factor concentrates at reversing modifications of hemostatic mechanisms induced by moderately elevated concentrations of apixaban (200 ng/ml added in vitro to blood from healthy donors (n = 10. Effects on thrombin generation (TG and thromboelastometry (TEM parameters were assessed. Modifications in platelet adhesive, aggregating and procoagulant activities were evaluated in studies with blood circulating through damaged vascular surfaces, at a shear rate of 600 s(-1. The potential of prothrombin complex concentrates (PCCs; 50 IU/kg, activated prothrombin complex concentrates (aPCCs; 75 IU/kg, or activated recombinant factor VII (rFVIIa; 270 μg/kg, at reversing the antihemostatic actions of apixaban, were investigated. Apixaban interfered with TG kinetics. Delayed lag phase, prolonged time to peak and reduced peak values, were improved by the different concentrates, though modifications in TG patterns were diversely affected depending on the activating reagents. Apixaban significantly prolonged clotting times (CTs in TEM studies. Prolongations in CTs were corrected by the different concentrates with variable efficacies (rFVIIa≥aPCC>PCC. Apixaban significantly reduced fibrin and platelet interactions with damaged vascular surfaces in perfusion studies (p<0.05 and p<0.01, respectively. Impairments in fibrin formation were normalized by the different concentrates. Only rFVIIa significantly restored levels of platelet deposition. Alterations in hemostasis induced by apixaban were variably compensated by the different factor concentrates investigated. However, effects of these concentrates were not homogeneous in all the tests, with PCCs showing more efficacy in TG, and rFVIIa being more effective

  10. The Use of the Ratio between the Veno-arterial Carbon Dioxide Difference and the Arterial-venous Oxygen Difference to Guide Resuscitation in Cardiac Surgery Patients with Hyperlactatemia and Normal Central Venous Oxygen Saturation

    Institute of Scientific and Technical Information of China (English)

    Wei Du; Yun Long; Xiao-Ting Wang; Da-Wei Liu

    2015-01-01

    Background:After cardiac surgery,central venous oxygen saturation (ScvO2) and serum lactate concentration are often used to guide resuscitation;however,neither are completely reliable indicators of global tissue hypoxia.This observational study aimed to establish whether the ratio between the veno-arterial carbon dioxide and the arterial-venous oxygen differences (P(v-a)CO2/C(a-v)O2) could predict whether patients would respond to resuscitation by increasing oxygen delivery (DO2).Methods:We selected 72 patients from a cohort of 290 who had undergone cardiac surgery in our institution between January 2012 and August 2014.The selected patients were managed postoperatively on the Intensive Care Unit,had a normal ScvO2,elevated serum lactate concentration,and responded to resuscitation by increasing DO2 by >10%.As a consequence,48 patients responded with an increase in oxygen consumption (VO2) while VO2 was static or fell in 24.Results:At baseline and before resuscitative intervention in postoperative cardiac surgery patients,a P(v-a)CO2/C(a-v)O2 ratio ≥1.6 mmHg/ml predicted a positive VO2 response to an increase in DO2 of>1 0% with a sensitivity of 68.8% and a specificity of 87.5%.Conclusions:P(v-a)CO2/C(a-v)O2 ratio appears to be a reliable marker of global anaerobic metabolism and predicts response to DO2 challenge.Thus,patients likely to benefit from resuscitation can be identified promptly,the P(v-a)CO2/C(a-v)O2 ratio may,therefore,be a useful resuscitation target.

  11. Bowel habits after bariatric surgery.

    Science.gov (United States)

    Potoczna, Natascha; Harfmann, Susanne; Steffen, Rudolf; Briggs, Ruth; Bieri, Norman; Horber, Fritz F

    2008-10-01

    Disordered bowel habits might influence quality of life after bariatric surgery. Different types of bariatric operations-gastric banding (AGB), Roux-en-Y gastric bypass (RYGB), or biliopancreatic diversion (BPD)-might alter bowel habits as a consequence of the surgical procedure used. Whether change in bowel habits affects quality of life after AGB, RYGB, or BPD differently is unknown. The study group contained 290 severely obese patients undergoing bariatric surgery between August 1996 and September 2004 [BPD: n = 103, 64.1% women, age 43 +/- 1 years (mean +/- SEM), BMI 53.9 +/- 0.9 kg/m(2), weight 153.4 +/- 2.9 kg; Roux-en-Y gastric bypass: n = 126, 73.0% women, age 43 +/- 1 years, BMI 44.2 +/- 0.3 kg/m(2), weight 123.8 +/- 1.5 kg; adjustable gastric banding (AGB): n = 61, 57.4% women, age 44 +/- 1 years, BMI 49.9 +/- 0.5 kg/m(2), weight 146.1 +/- 2.0 kg). Changes in bowel habits, flatulence, flatus odor, and effects on social life were estimated at least 4 months after surgery using a self-administered questionnaire. Fecal consistency changed significantly after surgery. Loose stools and diarrhea were more frequent after BPD and RYGB (P flatus affecting social life was more frequent after BPD than after either RYGB or AGB (P flatus frequency increased after BPD and RYGB, and patients were more bothered by their malodorous flatus than after AGB (all P Flatus severity score was highest in BPD, intermediate in RYGB, and lowest in AGB patients (all P < 0.001), a difference that was not influenced by frequency of metabolic syndrome before and after surgery. Moreover, observation period after surgery had no influence on overall results of bowel habits. Subsore quality of life bariatric analysis and reporting outcome system (BAROS) scores were largely similar between all three groups. However, flatulence severity score correlated inversely with quality of life estimated by BAROS in BPD and RYGB, but not in AGB patients. The type of bariatric surgery affects bowel

  12. Hand Surgery – Postoperative Recovery and Medical Tourism

    Directory of Open Access Journals (Sweden)

    Ruxandra Diana Sinescu

    2014-11-01

    Full Text Available Medical tourism is a growing industry worldwide. Romania has spa treatment facilities that can ensure the development of medical tourism. This article presents a statistical analysis of hand surgery in Romania in 2012. Using adequate quantitative methods we highlight significant differences between age groups and differences regarding procedures that have gender particularities. Recovery after such surgery can be achieved through spa treatment Romania, taking advantage of lower prices compared to other developed countries and numerous medical tourism facilities.

  13. Training general surgery residents in pediatric surgery: educational value vs time and cost.

    Science.gov (United States)

    Lee, Steven L; Sydorak, Roman M; Applebaum, Harry

    2009-01-01

    This study evaluated the educational value of pediatric surgery rotations, the likelihood of performing pediatric operations upon completing general surgery (GS) residency, and time and cost of training GS residents in pediatric surgery. A survey was administered to GS residents that evaluated the pediatric surgery rotation and anticipated practice intentions. A retrospective analysis (2005-2006) of operative times for unilateral inguinal hernia repair, bilateral inguinal hernia repair, and umbilical hernia repair was also performed. Procedure times were compared for operations performed by a pediatric surgeon with and without GS residents. Cost analysis was based on time differences. General surgery residents (n = 19) considered the pediatric surgery rotation to have high educational value (4.7 +/- 0.6 of 5) with extensive teaching (4.6 +/- 0.7) and operative experience (4.4 +/- 0.8). Residents listed pediatric surgery exposure, operative technique, and observed work ethic as most valuable. Upon graduation, residents expect to perform pediatric operations 2 to 3 times annually. Thirty-seven percent of residents felt competent to perform appendectomy (patients >5 years), 32% appendectomy (3-5 years), 21% gastrostomy (>1 year), and 11% inguinal herniorrhaphy (>1 year). Operative times and costs were significantly higher in operative procedures performed with a GS resident. General surgery residents considered pediatric surgery as a valuable educational experience. Residents anticipate performing pediatric operations a few times annually. Training GS residents in pediatric surgery increased operative time and cost. This information may be useful in determining the appropriate setting for resident education as well as budget planning for pediatric surgical practices.

  14. Comparative evaluation of two different loading doses of dexmedetomidine with midazolam-fentanyl for sedation in vitreoretinal surgery under peribulbar anaesthesia

    Directory of Open Access Journals (Sweden)

    Suman Shree Ramaswamy

    2016-01-01

    Full Text Available Background and Aims: Midazolam-fentanyl (MDZ:FEN combination has been routinely used for intravenous sedation in ophthalmic surgeries. Dexmedetomidine (DEX, a recent α2 adrenoreceptor agonist indicated for sedation for ophthalmic use at a loading dose of 0.5 μg/kg over 10 min, can cause deeper plane of sedation and surgeon dissatisfaction. Therefore, we proposed to evaluate the efficacy and safety of two different loading doses of DEX. Methods: In a prospective study, 60 patients aged 50-70 years, scheduled for retinal surgery under peribulbar block were divided equally to receive either MDZ:FEN or DEX 0.5 μg/kg (DEX full or DEX 0.25 μg/kg (DEX half loading dose over 10 min followed by titrated maintenance dose of DEX 0.25-0.4 μg/kg/h. Vital parameters, level of sedation (Ramsay Sedation Scale 1–6, effect on respiration and surgeon satisfaction were assessed at regular intervals. Surgeon satisfaction score (0–3 was noted. Results: 'DEX half' group patients had predominantly stable haemodynamics, level 3 sedation and surgeon satisfaction score of 2–3 (good to excellent operating conditions. This group had no vomiting and no respiratory depression. 'DEX full' group had a higher incidence of bradycardia, hypotension, level 4 sedation (Ramsay Sedation Scale and lower surgeon satisfaction. Incidence of nausea and vomiting was higher in MDZ:FEN group compared to other two groups. Conclusion: DEX 0.25 μg/kg loading dose over 10 min followed by titrated maintenance dose is an effective alternative to MDZ:FEN and provides controlled (level 3 sedation and stable haemodynamics maximising surgeon satisfaction. Avoiding narcotic analgesics with its associated post-operative nausea and vomiting is an additional benefit.

  15. SpO2 and Heart Rate During a Real Hike at Altitude Are Significantly Different than at Its Simulation in Normobaric Hypoxia

    Science.gov (United States)

    Netzer, Nikolaus C.; Rausch, Linda; Eliasson, Arn H.; Gatterer, Hannes; Friess, Matthias; Burtscher, Martin; Pramsohler, Stephan

    2017-01-01

    Rationale: Exposures to simulated altitude (normobaric hypoxia, NH) are frequently used in preparation for mountaineering activities at real altitude (hypobaric hypoxia, HH). However, physiological responses to exercise in NH and HH may differ. Unfortunately clinically useful information on such differences is largely lacking. This study therefore compared exercise responses between a simulated hike on a treadmill in NH and a similar field hike in HH. Methods: Six subjects (four men) participated in two trials, one in a NH chamber and a second in HH at an altitude of 4,205 m on the mountain Mauna Kea. Subjects hiked in each setting for 7 h including breaks. In NH, hiking was simulated by walking on a treadmill. To achieve maximal similarity between hikes, subjects used the same nutrition, clothes, and gear weight. Measurements of peripheral oxygen saturation (SpO2), heart rate (HR) and barometrical pressure (PB)/inspired oxygen fraction (FiO2) were taken every 15 min. Acute mountain sickness (AMS) symptoms were assessed using the Lake-Louise-Score at altitudes of 2,800, 3,500, and 4,200 m. Results: Mean SpO2 values of 85.8% in NH were significantly higher compared to those of 80.2% in HH (p = 0.027). Mean HR values of 103 bpm in NH were significantly lower than those of 121 bpm in HH (p = 0.029). AMS scores did not differ significantly between the two conditions. Conclusion: Physiological responses to exercise recorded in NH are different from those provoked by HH. These findings are of clinical importance for subjects using simulated altitude to prepare for activity at real altitude. Trial registration: Registration at DRKS. (Approval No. 359/12, Trial No. DRKS00005241). PMID:28243206

  16. Uso tópico da adrenalina em diferentes concentrações na cirurgia endoscópica nasal Topical use of adrenaline in different concentrations for endoscopic sinus surgery

    Directory of Open Access Journals (Sweden)

    Krishnamurti Matos de Araujo Sarmento Junior

    2009-04-01

    Full Text Available A concentração ideal de adrenalina tópica a promover hemostasia adequada sem toxicidade ainda é motivo de controvérsia. OBJETIVO: Comparar soluções tópicas de adrenalina em diferentes concentrações. DESENHO DO ESTUDO: Prospectivo, duplo-cego, seleção aleatória. MATERIAIS E MÉTODOS: 49 pacientes submetidos à cirurgia endoscópica nasal, divididos em 3 grupos usando exclusivamente adrenalina tópica, nas concentrações de 1:2000, 1:10.000 e 1:50.000. Comparou-se o tempo operatório, o sangramento, as concentrações plasmáticas de adrenalina e noradrenalina e a variação dos parâmetros cardiovasculares. RESULTADOS: O tempo operatório por procedimento foi menor no grupo que utilizou adrenalina 1:2000, assim como o sangramento (p The ideal adrenaline concentration remains unknown. AIM: Compare topical adrenaline solutions in different concentrations. STUDY DESIGN: Prospective, double blind, randomized trial. PATIENTS AND METHODS: 49 patients divided in 3 groups underwent endoscopic sinus surgery, using only topical solutions of adrenaline in different concentrations (1:2,000, 1:10,000 and 1:50,000. We compared the duration of surgery, intra-operative bleeding, plasmatic levels of catecholamines, hemodynamic parameters and changes in heart rhythm. RESULTS: Surgery time was shorter in the group using adrenaline 1:2,000, which also showed less bleeding in all evaluations (objective and subjective - p < 0.0001. Plasmatic levels of epinephrine rose in all groups, more sharply in the 1:2,000 group. There was a trend towards elevation of blood pressure in the groups using adrenaline 1:2,000 and 1:10,000, with a greater occurrence of hypertensive peaks. DISCUSSION: We found a very significance bleeding difference favoring the 1:2,000. The blood pressure elevation in the 1:2,000 and 1:10,000 groups was progressive but very slow throughout the procedure, which could be associated with the anesthesia technique. CONCLUSION: We favor the use

  17. Changes in adhesion molecule expression and oxidative burst activity of granulocytes and monocytes during open-heart surgery with cardiopulmonary bypass compared with abdominal surgery

    DEFF Research Database (Denmark)

    Toft, P; Nielsen, C H; Tønnesen, Else Kirstine

    1998-01-01

    Cardiac and major abdominal surgery are associated with granulocytosis in peripheral blood. The purpose of the present study was to describe the granulocyte and monocyte oxidative burst and the expression of adhesion molecules following cardiac surgery with cardiopulmonary bypass and abdominal...... surgery, 1, 5, 10 and 20 min after aortic clamping, and then 1, 5, 10 and 20 min and 1, 2 and 3 h after declamping. Samples from eight patients undergoing abdominal surgery were taken before surgery, at the end of surgery, and 2 and 3 h post-operatively. A decrease in number of granulocytes and monocytes...... burst of the granulocytes and monocytes decreased after declamping to 15% and 27% of initial values in vitro. Several hours after surgery, there was no significant difference between the two groups. These results can be explained by a granulocyte and monocyte refractory response developing subsequent...

  18. The results of ab interno laser thermal sclerostomy combined with cataract surgery versus trabeculectomy combined with cataract surgery 6 to 12 months postoperatively.

    Science.gov (United States)

    Kendrick, R; Kollarits, C R; Khan, N

    1996-07-01

    When cataract surgery and glaucoma surgery are combined, the theoretical advantages of pressure control, removal of the visual impairment, and protection against an increase in intraocular pressure (IOP) in the immediate postoperative period are gained. The authors' objective was to determine whether ab interno laser thermal sclerostomy (LTS) combined with cataract surgery would be as effective as trabeculectomy combined with cataract surgery. Ab interno LTS was compared with trabeculectomy, retrospectively, for patients who had undergone combined cataract and glaucoma surgery. There was no significant difference in the numbers of patients using no medications or fewer medications at 6 and 12 months. There was a greater reduction in IOP in the LTS group. LTS may be better than trabeculectomy in combined cataract and glaucoma surgery because it reduces the IOP more. Compared with trabeculectomy, LTS is simpler to perform and adds less operating time to cataract surgery. Continued follow-up is recommended.

  19. An integrated orthognathic surgery system for virtual planning and image-guided transfer without intermediate splint.

    Science.gov (United States)

    Kim, Dae-Seung; Woo, Sang-Yoon; Yang, Hoon Joo; Huh, Kyung-Hoe; Lee, Sam-Sun; Heo, Min-Suk; Choi, Soon-Chul; Hwang, Soon Jung; Yi, Won-Jin

    2014-12-01

    Accurate surgical planning and transfer of the planning in orthognathic surgery are very important in achieving a successful surgical outcome with appropriate improvement. Conventionally, the paper surgery is performed based on a 2D cephalometric radiograph, and the results are expressed using cast models and an articulator. We developed an integrated orthognathic surgery system with 3D virtual planning and image-guided transfer. The maxillary surgery of orthognathic patients was planned virtually, and the planning results were transferred to the cast model by image guidance. During virtual planning, the displacement of the reference points was confirmed by the displacement from conventional paper surgery at each procedure. The results of virtual surgery were transferred to the physical cast models directly through image guidance. The root mean square (RMS) difference between virtual surgery and conventional model surgery was 0.75 ± 0.51 mm for 12 patients. The RMS difference between virtual surgery and image-guidance results was 0.78 ± 0.52 mm, which showed no significant difference from the difference of conventional model surgery. The image-guided orthognathic surgery system integrated with virtual planning will replace physical model surgical planning and enable transfer of the virtual planning directly without the need for an intermediate splint.

  20. Juice, pulp and seeds fractionated from dry climate primocane raspberry cultivars (Rubus idaeus) have significantly different antioxidant capacity, anthocyanin content and color.

    Science.gov (United States)

    Snyder, Shannon M; Low, Richard M; Stocks, Janet C; Eggett, Dennis L; Parker, Tory L

    2012-12-01

    Raspberries contain flavonoid antioxidants whose relative concentrations may vary between the juice, pulp, and seed fractions. Oxygen radical absorbance capacity (ORAC), total anthocyanin content, and berry color were determined for six cultivars of primocane raspberries grown in a dry climate (Utah, USA). Significant ORAC differences were found between juice (18.4 ± 0.39 μmol TE/g), pulp (24.45 ± 0.43), and seeds (273.27 ± 11.15) with all Utah cultivars combined. A significantly higher concentration of anthocyanins was present in Utah raspberry juice (20.86 ± 0.35 mg cyanidin-3-glucoside eq./100 g), compared to pulp (13.96 ± 0.35). Anthocyanin content of juice and pulp were significantly positively correlated with dark color (L*). This is the first report of fractional differences in dry climate raspberries, and has implications for the juice and supplement industries.

  1. Providing Preoperative Information for Children Undergoing Surgery: A Randomized Study Testing Different Types of Educational Material to Reduce Children's Preoperative Worries

    Science.gov (United States)

    Fernandes, S. C.; Arriaga, P.; Esteves, F.

    2014-01-01

    This study developed three types of educational preoperative materials and examined their efficacy in preparing children for surgery by analysing children's preoperative worries and parental anxiety. The sample was recruited from three hospitals in Lisbon and consisted of 125 children, aged 8-12 years, scheduled to undergo outpatient surgery. The…

  2. Providing Preoperative Information for Children Undergoing Surgery: A Randomized Study Testing Different Types of Educational Material to Reduce Children's Preoperative Worries

    Science.gov (United States)

    Fernandes, S. C.; Arriaga, P.; Esteves, F.

    2014-01-01

    This study developed three types of educational preoperative materials and examined their efficacy in preparing children for surgery by analysing children's preoperative worries and parental anxiety. The sample was recruited from three hospitals in Lisbon and consisted of 125 children, aged 8-12 years, scheduled to undergo outpatient surgery.…

  3. All-atom molecular dynamics simulations reveal significant differences in interaction between antimycin and conserved amino acid residues in bovine and bacterial bc1 complexes.

    Science.gov (United States)

    Kokhan, Oleksandr; Shinkarev, Vladimir P

    2011-02-02

    Antimycin A is the most frequently used specific and powerful inhibitor of the mitochondrial respiratory chain. We used all-atom molecular dynamics (MD) simulations to study the dynamic aspects of the interaction of antimycin A with the Q(i) site of the bacterial and bovine bc(1) complexes embedded in a membrane. The MD simulations revealed considerable conformational flexibility of antimycin and significant mobility of antimycin, as a whole, inside the Q(i) pocket. We conclude that many of the differences in antimycin binding observed in high-resolution x-ray structures may have a dynamic origin and result from fluctuations of protein and antimycin between multiple conformational states of similar energy separated by low activation barriers, as well as from the mobility of antimycin within the Q(i) pocket. The MD simulations also revealed a significant difference in interaction between antimycin and conserved amino acid residues in bovine and bacterial bc(1) complexes. The strong hydrogen bond between antimycin and conserved Asp-228 (bovine numeration) was observed to be frequently broken in the bacterial bc(1) complex and only rarely in the bovine bc(1) complex. In addition, the distances between antimycin and conserved His-201 and Lys-227 were consistently larger in the bacterial bc(1) complex. The observed differences could be responsible for a weaker interaction of antimycin with the bacterial bc(1) complex.

  4. The effect of residency and fellowship type on hand surgery clinical practice patterns.

    Science.gov (United States)

    Mehta, Karan; Pierce, Paul; Chiu, David T W; Thanik, Vishal

    2015-01-01

    The Accreditation Council for Graduate Medical Education requires accredited fellowship programs to exhibit proficiency in six broadly defined domains; however, core competencies specifically mandated for hand surgery training have yet to be established. Several studies have demonstrated significant disparities in exposure to essential skills and knowledge between orthopedic surgery- and plastic surgery-based hand surgery fellowship programs. To determine whether significant discrepancies also exist after fellowship between hand surgeons trained in orthopedic surgery and those trained in plastic surgery, clinical practice patterns were evaluated. A 20-question survey was created and distributed electronically to American Society for Surgery of the Hand and American Association for Hand Surgery members. Responses were compared using descriptive statistics. Nine hundred eighty-two hand surgeons (76 percent orthopedic and 24 percent plastic) responded, representing a 39 percent response rate. Most plastic surgery hand practices were academic-based (41 percent), whereas orthopedic practices were private (67 percent). More orthopedic hand surgeons worked in multipractitioner practices than plastic surgeons (54 percent versus 30 percent; p digital replantation cases (53 percent versus 22 percent; p < 0.05) but treated significantly fewer open reduction and internal fixation distal radius fractures. Orthopedic and plastic surgery hand surgeons differ significantly in their clinical practice patterns. Differences in clinical exposure during training are reflected in practice and persist over time. Referral patterns and practice situations are also contributors to ultimate practice patterns.

  5. Skeletal stability of surgery-first bimaxillary orthognathic surgery for skeletal class III malocclusion, using standardized criteria.

    Science.gov (United States)

    Park, K-H; Sandor, G K; Kim, Y-D

    2016-01-01

    The purpose of this study was to compare the postoperative stability following bimaxillary surgery performed either with or without preoperative orthodontic treatment, in class III malocclusion patients. These patients were enrolled using standardized inclusion criteria. Forty patients with a class III malocclusion were included in this retrospective study. Inclusion criteria were class III malocclusion with and without premolar extraction, <3mm midline deviation, and <5mm arch width discordance. Patients were assigned to the conventional bimaxillary surgery group (n=20) or the surgery-first bimaxillary surgery group (n=20). Serial cephalometric radiographs obtained before surgery (T0), at 2 months after surgery (T1), and at 6 months after surgery (T2) were used to assess the variation in surgical change (T0 to T1) and postsurgical change (T1 to T2). Eight linear and three angular parameters were used to evaluate postoperative stability. With respect to postsurgical changes, significant differences were observed in the changes for the vertical reference plane to the posterior nasal spine, horizontal reference plane to B-point, and occlusal plane angle in both groups. No statistically significant differences in the relapse rates were observed between the two groups. No significant differences were observed between the two groups in terms of the postoperative stability.

  6. Expression and significance of IL-1β and COX-2 in gingiva tissues in rat periodontitis model with different estrogen levels

    Institute of Scientific and Technical Information of China (English)

    Li-Bo Ku; Guo-Quan Xu; Hui Wang; Zhi-Hua Zhao; Shi-Yu Ding; Li Ma

    2017-01-01

    Objective:To explore the expressions of IL-1β and COX-2 in the gingiva tissues in rat periodontitis model with different estrogen levels, and the effect of estrogen level on periodontitis.Methods:A total of 40 female Wistar rats were randomized into 4 groups, i.e. normal control group (n=10), periodontitis group (n=10), castraction periodontitis group (n=10), and estrogen therapy group (n=10). RT-PCR was used to detect the expressions of IL-1β and COX-2 in the gingiva tissues in each group.Results:The expression intensity of IL-1β and COX-2 in the estrogen therapy group was significantly lower than that in the castraction periodontitis group (P<0.05).Conclusions:Estrogen can significantly down regulate the expressions of IL-1β and COX-2 in order to alleviate the symptoms of periodontitis.

  7. Significant genotype difference in the CYP2E1 PstI polymorphism of indigenous groups in Sabah, Malaysia with Asian and non-Asian populations.

    Science.gov (United States)

    Goh, Lucky Poh Wah; Chong, Eric Tzyy Jiann; Chua, Kek Heng; Chuah, Jitt Aun; Lee, Ping-Chin

    2014-01-01

    CYP2E1 PstI polymorphism G-1259C (rs3813867) genotype distributions vary significantly among different populations and are associated with both diseases, like cancer, and adverse drug effects. To date, there have been limited genotype distributions and allele frequencies of this polymorphism reported in the three major indigenous ethnic groups (KadazanDusun, Bajau, and Rungus) in Sabah, also known as North Borneo. The aim of this study was to investigate the genotype distributions and allele frequencies of the CYP2E1 PstI polymorphism G-1259C in these three major indigenous peoples in Sabah. A total of 640 healthy individuals from the three dominant indigenous groups were recruited for this study. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) at G-1259C polymorphic site of CYP2E1 gene was performed using the Pst I restriction enzyme. Fragments were analyzed using agarose gel electrophoresis and confirmed by direct sequencing. Overall, the allele frequencies were 90.3% for c1 allele and 9.7% for c2 allele. The genotype frequencies for c1/c1, c1/c2 and c2/c2 were observed as 80.9%, 18.8%, and 0.3%, respectively. A highly statistical significant difference (ppopulations. However, among these three indigenous groups, there was no statistical significant difference (p>0.001) in their genotype distributions. The three major indigenous ethnic groups in Sabah show unique genotype distributions when compared with other populations. This finding indicates the importance of establishing the genotype distributions of CYP2E1 PstI polymorphism in the indigenous populations.

  8. Superfund explanation of significant difference for the record of decision (EPA Region 3): Fairchild, Intel, and Raytheon Sites, (Mew Study Area), Mountain View, CA, September 1990

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-02-01

    The purpose of the document is to explain the significant differences between the Record of Decision (ROD) signed by the U.S. Environmental Protection Agency (EPA) on June 9, 1989 (PB90-118225) and the remedy that will be implemented at the Middlefield/Ellis/Whisman Study Area (MEW Site). The document provides a brief background on the MEW Site, describes the change to the ROD that EPA is now making and explains the ways in which this change affects implementation of the remedy selected by EPA in June of 1989.

  9. Multiscale mechanobiology modeling for surgery assessment

    Institute of Scientific and Technical Information of China (English)

    M. Garbey; B. L. Bass; S. Berceli

    2012-01-01

    This paper discusses some of the concept of modeling surgery outcome.It is also an attempt to offer a road map for progress.This paper may serve as a common ground of discussion for both communities i.e surgeons and computational scientist in its broadest sense.Predicting surgery outcome is a very difficult task.All patients are different,and multiple factors such as genetic,or environment conditions plays a role.The difficulty is to construct models that are complex enough to address some of these significant multiscale elements and simple enough to be used in clinical conditions and calibrated on patient data.We will provide a multilevel progressive approach inspired by two applications in surgery that we have been working on.One is about vein graft adaptation after a transplantation,the other is the recovery of cosmesis outcome after a breast lumpectomy.This work,that is still very much in progress,may teach us some lessons.We are convinced that the digital revolution that is transforming the working environment of the surgeon makes closer collaboration between surgeons and computational scientist unavoidable.We believe that "computational surgery" will allow the community to develop predictive model of the surgery outcome and greatprogresses in surgery procedures that goes far beyond the operating room procedural aspect.

  10. CARDIOTHORACIC SURGERY

    African Journals Online (AJOL)

    lbadan, Nigeria. Reprint requests to: Dr. V. O. Adegboye, Department Of Surgery, University College Hospital, Iberian,. Nigeria. ... been shown to be related to the rate of bleeding. .... patients after an interval of conservative/medical treatment.

  11. General Surgery

    African Journals Online (AJOL)

    bbshehu

    underwent major colonic restorative resection between July 1997 and September 199 in order to ... factors, the level of anastomosis and the experience of the surgeon are perhaps the ... indications for surgery and cancer stage were similar.

  12. Brain surgery

    Science.gov (United States)

    Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy ... cut depends on where the problem in the brain is located. The surgeon creates a hole in ...

  13. Hemorrhoid surgery

    Science.gov (United States)

    ... and hemorrhoidectomy. In: Delaney CP, ed. Netter's Surgical Anatomy and Approaches . Philadelphia, PA: Elsevier Saunders; 2014:chap 26. Review Date 4/5/2015 Updated by: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason ...

  14. GENERAL SURGERY

    African Journals Online (AJOL)

    The traditional operative approach is an open surgical one to drain the cysts and ... early outcomes of laparoscopic treatment of liver hydatid cysts at our institution. .... O. Radical vs. conservative surgery for hydatid liver cysts: Experience from ...

  15. Outpatient Surgery

    Science.gov (United States)

    ... thirds of all operations are performed in outpatient facilities, according to the Centers for Disease Control and Prevention. Outpatient surgery provides patients with the convenience of recovering at home, and can cost less. ...

  16. Laparoscopic Surgery

    Science.gov (United States)

    ... surgeon’s perspective, laparoscopic surgery may allow for easier dissection of abdominal scar tissue (adhesions), less surgical trauma, ... on Facebook About ACG ACG Store ACG Patient Education & Resource Center Home GI Health and Disease Recursos ...

  17. Rest and stress transluminal attenuation gradient and contrast opacification difference for detection of hemodynamically significant stenoses in patients with suspected coronary artery disease.

    Science.gov (United States)

    Ko, Brian S; Seneviratne, Sujith; Cameron, James D; Gutman, Sarah; Crossett, Marcus; Munnur, Kiran; Meredith, Ian T; Wong, Dennis T L

    2016-07-01

    This study evaluated the feasibility of stress 320 detector CT coronary angiography (CTA) derived transluminal attenuation gradient (TAG320) and contrast opacification (CO) difference to detect hemodynamically significant stenoses as determined by invasive fractional flow reserve (FFR ≤ 0.80). Twenty-seven patients, including 51 vessels on rest CTA were studied. 16 (31 %) vessels were not interpretable on stress CTA largely secondary to motion artefacts. Receiver operating characteristic curve analysis showed a comparable area under the curve (AUC) for rest and stress TAG320 (0.78 and 0.75) which was higher than CTA alone (0.68), and rest and stress CO difference (0.76 and 0.67). Compared with rest CTA, stress CTA demonstrated inferior image quality (Median Likert score 4 vs. 3, P < 0.0001) and required a higher mean radiation exposure (3.2 vs. 5.1 mSv, P < 0.0001). Stress TAG320 and CO difference is less feasible and was not superior in diagnostic performance when compared with rest TAG320 and CO difference.

  18. Emergency surgery

    DEFF Research Database (Denmark)

    Stoneham, M; Murray, D; Foss, N

    2014-01-01

    National reports recommended that peri-operative care should be improved for elderly patients undergoing emergency surgery. Postoperative mortality and morbidity rates remain high, and indicate that emergency ruptured aneurysm repair, laparotomy and hip fracture fixation are high-risk procedures...... undertaken on elderly patients with limited physiological reserve. National audits have reported variations in care quality, data that are increasingly being used to drive quality improvement through professional guidance. Given that the number of elderly patients presenting for emergency surgery is likely...

  19. No major differences in 30-day outcomes in high-risk patients randomized to off-pump versus on-pump coronary bypass surgery: the best bypass surgery trial

    DEFF Research Database (Denmark)

    Møller, Christian H; Perko, Mario J; Lund, Jens T

    2010-01-01

    Off-pump coronary artery bypass grafting compared with coronary revascularization with cardiopulmonary bypass seems safe and results in about the same outcome in low-risk patients. Observational studies indicate that off-pump surgery may provide more benefit in high-risk patients. Our objective w...

  20. [Robotic surgery].

    Science.gov (United States)

    Moreno-Portillo, Mucio; Valenzuela-Salazar, Carlos; Quiroz-Guadarrama, César David; Pachecho-Gahbler, Carlos; Rojano-Rodríguez, Martín

    2014-12-01

    Medicine has experienced greater scientific and technological advances in the last 50 years than in the rest of human history. The article describes relevant events, revises concepts and advantages and clinical applications, summarizes published clinical results, and presents some personal reflections without giving dogmatic conclusions about robotic surgery. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) defines robotic surgery as a surgical procedure using technology to aid the interaction between surgeon and patient. The objective of the surgical robot is to correct human deficiencies and improve surgical skills. The capacity of repeating tasks with precision and reproducibility has been the base of the robot´s success. Robotic technology offers objective and measurable advantages: - Improving maneuverability and physical capacity during surgery. - Correcting bad postural habits and tremor. - Allowing depth perception (3D images). - Magnifying strength and movement limits. - Offering a platform for sensors, cameras, and instruments. Endoscopic surgery transformed conceptually the way of practicing surgery. Nevertheless in the last decade, robotic assisted surgery has become the next paradigm of our era.

  1. Laparoscopic surgery for colorectal cancer is safe and has survival outcomes similar to those of open surgery in elderly patients with a poor performance status: subanalysis of a large multicenter case-control study in Japan.

    Science.gov (United States)

    Niitsu, Hiroaki; Hinoi, Takao; Kawaguchi, Yasuo; Ohdan, Hideki; Hasegawa, Hirotoshi; Suzuka, Ichio; Fukunaga, Yosuke; Yamaguchi, Takashi; Endo, Shungo; Tagami, Soichi; Idani, Hitoshi; Ichihara, Takao; Watanabe, Kazuteru; Watanabe, Masahiko

    2016-01-01

    It remains controversial whether open or laparoscopic surgery should be indicated for elderly patients with colorectal cancer and a poor performance status. In those patients aged 80 years or older with Eastern Cooperative Oncology Group performance status score of 2 or greater who received elective surgery for stage 0 to stage III colorectal adenocarcinoma and had no concomitant malignancies and who were enrolled in a multicenter case-control study entitled "Retrospective study of laparoscopic colorectal surgery for elderly patients" that was conducted in Japan between 2003 and 2007, background characteristics and short-term and long-term outcomes for open surgery and laparoscopic surgery were compared. Of the 398 patients included, 295 underwent open surgery and 103 underwent laparoscopic surgery. There were no significant differences in the baseline characteristics between open surgery and laparoscopic surgery patients, except for previous abdominal surgery and TNM stage. The median operation duration was shorter with open surgery (open surgery, 153 min; laparoscopic surgery, 202 min; P cancer patients with a poor performance status is safe and not inferior to open surgery in terms of overall survival.

  2. Prognostic Significance of the Systemic Inflammatory and Immune Balance in Alcoholic Liver Disease with a Focus on Gender-Related Differences.

    Directory of Open Access Journals (Sweden)

    Beata Kasztelan-Szczerbińska

    Full Text Available Mechanisms of immune regulation in alcoholic liver disease (ALD are still unclear. The aim of our study was to determine an impact of Th17 / regulatory T (Treg cells balance and its corresponding cytokine profile on the ALD outcome. Possible gender-related differences in the alcohol-induced inflammatory response were also assessed.147 patients with ALD were prospectively recruited, assigned to subgroups based on their gender, severity of liver dysfunction and presence of ALD complications at admission, and followed for 90 days. Peripheral blood frequencies of Th17 and Treg cells together with IL-1beta, IL-6, IL-17A, IL-23, and TGF-beta1 levels were investigated. Flow cytometry was used to identify T cell phenotype and immunoenzymatic ELISAs for the corresponding cytokine concentrations assessment. Multivariable logistic regression was applied in order to select independent predictors of advanced liver dysfunction and the disease complications.IL-17A, IL-1beta, IL-6 levels were significantly increased, while TGF-beta1 decreased in ALD patients. The imbalance with significantly higher Th17 and lower Treg frequencies was observed in non-survivors. IL-6 and TGF-beta1 levels differed in relation to patient gender in ALD group. Concentrations of IL-6 were associated with the severity of liver dysfunction, development of ALD complications, and turned out to be the only independent immune predictor of 90-day survival in the study cohort.We conclude that IL-6 revealed the highest diagnostic and prognostic potential among studied biomarkers and was related to the fatal ALD course. Gender-related differences in immune regulation might influence the susceptibility to alcohol-associated liver injury.

  3. Young Mania Rating Scale: how to interpret the numbers? Determination of a severity threshold and of the minimal clinically significant difference in the EMBLEM cohort.

    Science.gov (United States)

    Lukasiewicz, Michael; Gerard, Stephanie; Besnard, Adeline; Falissard, Bruno; Perrin, Elena; Sapin, Helene; Tohen, Mauricio; Reed, Catherine; Azorin, Jean-Michel

    2013-03-01

    The aim of this analysis was to identify Young Mania Rating Scale (YMRS) meaningful benchmarks for clinicians (severity threshold, minimal clinically significant difference [MCSD]) using the Clinical Global Impressions Bipolar (CGI-BP) mania scale, to provide a clinical perspective to randomized clinical trials (RCTs) results. We used the cohort of patients with acute manic/mixed state of bipolar disorders (N = 3459) included in the European Mania in Bipolar Longitudinal Evaluation of Medication (EMBLEM) study. A receiver-operating characteristic analysis was performed on randomly selected patients to determine the YMRS optimal severity threshold with CGI-BP mania score ≥ "Markedly ill" defining severity. The MCSD (clinically meaningful change in score relative to one point difference in CGI-BP mania for outcome measures) of YMRS, was assessed with a linear regression on baseline data. At baseline, YMRS mean score was 26.4 (±9.9), CGI-BP mania mean score was 4.8 (±1.0) and 61.7% of patients had a score ≥ 5. The optimal YMRS severity threshold of 25 (positive predictive value [PPV] = 83.0%; negative predictive value [NPV] = 66.0%) was determined. In this cohort, a YMRS score of 20 (typical cutoff for RCTs inclusion criteria) corresponds to a PPV of 74.6% and to a NPV of 77.6%, meaning that the majority of patients included would be classified as severely ill. The YMRS minimal clinically significant difference was 6.6 points.

  4. Differences in the Cellular Response to Acute Spinal Cord Injury between Developing and Mature Rats Highlights the Potential Significance of the Inflammatory Response

    Science.gov (United States)

    Sutherland, Theresa C.; Mathews, Kathryn J.; Mao, Yilin; Nguyen, Tara; Gorrie, Catherine A.

    2017-01-01

    There exists a trend for a better functional recovery from spinal cord injury (SCI) in younger patients compared to adults, which is also reported for animal studies; however, the reasons for this are yet to be elucidated. The post injury tissue microenvironment is a complex milieu of cells and signals that interact on multiple levels. Inflammation has been shown to play a significant role in this post injury microenvironment. Endogenous neural progenitor cells (NPC), in the ependymal layer of the central canal, have also been shown to respond and migrate to the lesion site. This study used a mild contusion injury model to compare adult (9 week), juvenile (5 week) and infant (P7) Sprague-Dawley rats at 24 h, 1, 2, and 6 weeks post-injury (n = 108). The innate cells of the inflammatory response were examined using counts of ED1/IBA1 labeled cells. This found a decreased inflammatory response in the infants, compared to the adult and juvenile animals, demonstrated by a decreased neutrophil infiltration and macrophage and microglial activation at all 4 time points. Two other prominent cellular contributors to the post-injury microenvironment, the reactive astrocytes, which eventually form the glial scar, and the NPC were quantitated using GFAP and Nestin immunohistochemistry. After SCI in all 3 ages there was an obvious increase in Nestin staining in the ependymal layer, with long basal processes extending into the parenchyma. This was consistent between age groups early post injury then deviated at 2 weeks. The GFAP results also showed stark differences between the mature and infant animals. These results point to significant differences in the inflammatory response between infants and adults that may contribute to the better recovery indicated by other researchers, as well as differences in the overall injury progression and cellular responses. This may have important consequences if we are able to mirror and manipulate this response in patients of all ages; however

  5. Menstrual bleeding after cardiac surgery.

    Science.gov (United States)

    Hjortdal, Vibeke Elisabeth; Larsen, Signe Holm; Wilkens, Helena; Jakobsen, Anja; Pedersen, Thais Almeida Lins

    2014-01-01

    We investigated whether open-heart surgery with the use of extracorporeal circulation has an impact on menstrual bleeding. The menstrual bleeding pattern was registered in fertile women undergoing open-heart surgery in 2010-12. Haematocrit and 24-h postoperative bleeding were compared with those of men undergoing cardiac surgery. Women (n = 22), with mean age of 36 (range 17-60) years, were operated on and hospitalized for 4-5 postoperative days. The mean preoperative haematocrit was 40% (range 32-60%), and mean haematocrit at discharge was 32% (range 26-37%). Mean postoperative bleeding in the first 24 h was 312 (range 50-1442) ml. They underwent surgery for atrial septal defect (n = 5), composite graft/David procedure (n = 4), pulmonary or aortic valve replacement (n = 6), myxoma (n = 2), mitral valvuloplasty (n = 2), ascending aortic aneurysm (n = 1), aortic coarctation (n = 1) and total cavopulmonary connection (n = 1). Unplanned menstrual bleeding (lasting 2-5 days) was detected in 13 (60%) patients. Of them, 4 were 1-7 days early, 4 were 8-14 days early, 3 were 1-7 days late and 2 had menstruation despite having had menstrual bleeding within the last 2 weeks. None had unusually large or long-lasting menstrual bleeding. Ten women took oral contraceptives, 8 of whom had unexpected menstrual bleeding during admission. Men (n = 22), with a mean age of 35 (range 17-54) years, had mean bleeding of 331 (range 160-796) ml postoperatively, which was not statistically significantly different from the women's. The mean preoperative haematocrit was 40% (range 29-49%) among men, while haematocrit at discharge was 32% (28-41), not significantly different from that seen in the female subgroup. Menstrual bleeding patterns are disturbed by open-heart surgery in the majority of fertile women. Nevertheless, the unexpected menstrual bleeding is neither particularly long-lasting nor of large quantity, and the postoperative surgical bleeding is unaffected. We recommend that

  6. Metabolic surgery: quo vadis?

    Science.gov (United States)

    Ramos-Leví, Ana M; Rubio Herrera, Miguel A

    2014-01-01

    The impact of bariatric surgery beyond its effect on weight loss has entailed a change in the way of regarding it. The term metabolic surgery has become more popular to designate those interventions that aim at resolving diseases that have been traditionally considered as of exclusive medical management, such as type 2 diabetes mellitus (T2D). Recommendations for metabolic surgery have been largely addressed and discussed in worldwide meetings, but no definitive consensus has been reached yet. Rates of diabetes remission after metabolic surgery have been one of the most debated hot topics, with heterogeneity being a current concern. This review aims to identify and clarify controversies regarding metabolic surgery, by focusing on a critical analysis of T2D remission rates achieved with different bariatric procedures, and using different criteria for its definition. Indications for metabolic surgery for patients with T2D who are not morbidly obese are also discussed. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

  7. Photobiomodulation in laser surgery

    Science.gov (United States)

    Liu, Timon Cheng-Yi; Rong, Dong-Liang; Huang, Jin; Deng, Xiao-Yuan; Liu, Song-Hao

    2006-01-01

    Laser surgery provides good exposure with clear operating fields and satisfactory preliminary functional results. In contrast to conventional excision, it was found that matrix metalloproteinases and the tissue inhibitors of metalloproteinases -1 mRNA expression is higher, myofibroblasts appeared and disappeared slower in laser excision wounds. It has been suggested that the better anatomical and functional results achieved following laser cordectomy may be explained by the fact that such procedures result in better, more rapid healing processes to recover vocal cord for early glottic tumors and better. In this paper, the role of photobiomodulation in laser surgery will be discussed by the cultured monolayer normal human skin fibroblast model of the photobiomodulation of marginal irradiation of high intensity laser beam, the photobiomodulation related to the irradiated tissue, the biological information model of photobiomodulation and the animal models of laser surgery. Although high intensity laser beam is so intense that it destroys the irradiated cells or tissue, its marginal irradiation intensity is so low that there is photobiomodulation on non-damage cells to modulate the regeneration of partly damaged tissue so that the surgery of laser of different parameters results in different post-surgical recovery. It was concluded that photobiomodulation might play an important role in the long-term effects of laser surgery, which might be used to design laser surgery.

  8. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... find out more. Dental and Soft Tissue Surgery Dental and Soft Tissue Surgery Oral and facial surgeons ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, ...

  9. Tennis elbow surgery

    Science.gov (United States)

    Lateral epicondylitis - surgery; Lateral tendinosis - surgery; Lateral tennis elbow - surgery ... Surgery to repair tennis elbow is usually an outpatient surgery. This means you will not stay in the hospital overnight. You will be given ...

  10. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more ... find out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment ...

  11. Mohs micrographic surgery

    Science.gov (United States)

    Skin cancer - Mohs surgery; Basal cell skin cancer - Mohs surgery; Squamous cell skin cancer - Mohs surgery ... Mohs surgery usually takes place in the doctor's office. The surgery is started early in the morning and is ...

  12. Corrective Jaw Surgery

    Science.gov (United States)

    ... and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more ... find out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment ...

  13. Arterio-venous concentration difference of [51Cr]EDTA after a single injection in man. Significance of renal function and local blood flow

    DEFF Research Database (Denmark)

    Rehling, M; Hyldstrup, Lars; Henriksen, Jens Henrik

    1989-01-01

    introduced in the measurement of renal plasma clearance and total plasma clearance by using venous blood samples instead of arterial. In 13 patients with GFR ranging from 29 to 150 ml min-1, Ca was higher than Cv immediately after the injection. After mean 38 min (range 12-82 min) the two curves crossed......, and 180-300 min post-injection (p.i.) Cv was 5.9% higher than Ca (range 0.5-13.9%, P less than 0.001). The more reduced renal function, the smaller was the concentration difference. The areas under the arterial and the venous plasma concentration curves did not differ significantly at either 0-infinity......, whereas the difference was very sensitive to even small changes in forearm blood flow within the physiological range. For measurement of renal plasma clearance it is recommended to use one long period: from the time of injection until 300 min p.i. or longer. If the clearance period is too short, the use...

  14. Evaluation of high-concentration sevoflurane for induction and nasotracheal intubation without muscle relaxant for infants with different pulmonary blood flow undergoing surgery for congenital heart diseases.

    Science.gov (United States)

    Wang, Kai-Yuan; Wang, Hong-Wu; Xin, Lian-Feng; Wang, Yong-Wang; Xue, Yu-Liang

    2011-12-01

    Inhalational anesthesia with sevoflurane for endotracheal intubation without muscle relaxant is now used widely for pediatric patients. This study assessed the efficacy and safety of induction with high concentration sevoflurane and of nasotracheal intubation without muscle relaxant in infants with increased or decreased pulmonary blood flow (PBF) and undergoing surgery for congenital heart diseases. Fifty-five infants aged 2 - 12 months, weighing 4.7 - 10.0 kg, and scheduled for congenital cardiac surgery were enrolled. Subjects were divided into those with increased (IPBF group, n = 29) and decreased (DPBF group, n = 26) pulmonary blood flow. All infants received inhalational induction with 8% sevoflurane in 100.0% oxygen at a gas flow rate of 6 L/min. Nasotracheal intubation was performed 4 minutes after induction. Sevoflurane vaporization was decreased to 4.0% for placement of a peripheral intravenous line and invasive hemodynamic monitors. Five minutes later, sedatives and muscle relaxant were administered and the vaporizer was adjusted to 2% for maintenance of anesthesia. Bispectral index (BIS) scores, circulatory parameters, satisfactory and successful intubation ratios, adverse reactions, and complications of intubation were recorded. Times to loss of lash and pain reflexes were longer for the DPBF group (P intubation ratios were 93.1% and 61.5% for the IPBF and DPBF groups, respectively (P = 0.008). Successful intubation ratios were 96.6% and 76.9% for the IPBF and DPBF groups, respectively (P = 0.044). Following sevoflurane inhalation, blood pressures decreased significantly in the IPBF group but remained stable in the DPBF group. BIS scores declined to similar stable values, and a "nadir BIS" was recorded for both groups. No obvious adverse reactions or complications of intubation were noted perioperatively. Induction with high concentration sevoflurane, although faster for infants with IPBF, is safe for infants with IPBF or DPBF. However, nasotracheal

  15. Assessment of the Minimum Clinically Important Difference in the Timed Up and Go Test After Surgery for Lumbar Degenerative Disc Disease.

    Science.gov (United States)

    Gautschi, Oliver P; Stienen, Martin N; Corniola, Marco V; Joswig, Holger; Schaller, Karl; Hildebrandt, Gerhard; Smoll, Nicolas R

    2017-03-01

    The Timed Up and Go Test (TUG Test) has previously been described as a reliable tool to evaluate objective functional impairment in patients with degenerative disc disease. The aim of this study was to assess the minimum clinically important difference (MCID) of the TUG Test. The TUG Test (measured in seconds) was correlated with validated patient-reported outcome measures (PROs) of pain intensity (Visual Analog Scale for back and leg pain), functional impairment (Oswestry Disability Index, Roland Morris Disability Index), and health-related quality of life measures (Short Form-12 and EuroQol 5D). Three established methods were used to establish anchor-based MCID values using responders of the following PROs (Visual Analog Scale back and leg pain, Oswestry Disability Index, Roland Morris Disability Index, EuroQol 5D index, and Short Form-12 Physical Component Summary) as anchors: (1) average change, (2) minimum detectable change, and (3) change difference approach. One hundred patients with a mean ± SD age of 56.2 ± 16.1 years, 57 (57%) male, 45 patients undergoing microdiscectomy, 35 undergoing lumbar decompression, and 20 undergoing fusion surgery were studied. The 3 MCID computation methods revealed a range of MCID values according to the PRO used from 0.9 s (Oswestry Disability Index based on the change difference approach) to 6.0 s (EuroQol 5D index based on the minimum detectable change approach), with a mean MCID of 3.4 s for all measured PROs. The MCID for the TUG Test time is highly variable depending on the computation technique used. The average TUG Test MCID was 3.4 s using all 3 methods and all anchors.

  16. Visual outcome and impact on quality of life after surgeries differ in children operated for unilateral and bilateral cataract (Pune study 2011

    Directory of Open Access Journals (Sweden)

    Mukesh Paryani

    2012-01-01

    Conclusion: Vision and VQL improved in children with unilateral and bilateral cataract. However, it was better 6 months following surgery in children with bilateral cataract than in children with unilateral cataract.

  17. Effects of Noninvasive Positive-Pressure Ventilation with Different Interfaces in Patients with Hypoxemia after Surgery for Stanford Type A Aortic Dissection

    OpenAIRE

    Yang, Yi; Sun, Lizhong; Liu, Nan; Hou, Xiaotong; Wang, Hong; Jia, Ming

    2015-01-01

    Background Hypoxemia is a severe perioperative complication that can substantially increase intensive care unit and hospital stay and mortality. The aim of this study was to determine the effects of non-invasive positive-pressure ventilation (NIPPV) in patients with hypoxemia after surgery for Stanford type A aortic dissection, and to compare the effects of helmet and mask NIPPV. Material/Methods We recruited 40 patients who developed hypoxemia within 24 h after extubation after surgery for S...

  18. Robotic surgery in gynecology

    Directory of Open Access Journals (Sweden)

    Rooma Sinha

    2015-01-01

    Full Text Available FDA approved Da Vinci Surgical System in 2005 for gynecological surgery. It has been rapidly adopted and it has already assumed an important position at various centers where this is available. It comprises of three components: A surgeon′s console, a patient-side cart with four robotic arms and a high-definition three-dimensional (3D vision system. In this review we have discussed various robotic-assisted laparoscopic benign gynecological procedures like myomectomy, hysterectomy, endometriosis, tubal anastomosis and sacrocolpopexy. A PubMed search was done and relevant published studies were reviewed. Surgeries that can have future applications are also mentioned. At present most studies do not give significant advantage over conventional laparoscopic surgery in benign gynecological disease. However robotics do give an edge in more complex surgeries. The conversion rate to open surgery is lesser with robotic assistance when compared to laparoscopy. For myomectomy surgery, Endo wrist movement of robotic instrument allows better and precise suturing than conventional straight stick laparoscopy. The robotic platform is a logical step forward to laparoscopy and if cost considerations are addressed may become popular among gynecological surgeons world over.

  19. Robotic surgery.

    Science.gov (United States)

    Diana, M; Marescaux, J

    2015-01-01

    Proficiency in minimally invasive surgery requires intensive and continuous training, as it is technically challenging for unnatural visual and haptic perceptions. Robotic and computer sciences are producing innovations to augment the surgeon's skills to achieve accuracy and high precision during complex surgery. This article reviews the current use of robotically assisted surgery, focusing on technology as well as main applications in digestive surgery, and future perspectives. The PubMed database was interrogated to retrieve evidence-based data on surgical applications. Internal and external consulting with key opinion leaders, renowned robotics laboratories and robotic platform manufacturers was used to produce state-of-the art business intelligence around robotically assisted surgery. Selected digestive procedures (oesophagectomy, gastric bypass, pancreatic and liver resections, rectal resection for cancer) might benefit from robotic assistance, although the current level of evidence is insufficient to support widespread adoption. The surgical robotic market is growing, and a variety of projects have recently been launched at both academic and corporate levels to develop lightweight, miniaturized surgical robotic prototypes. The magnified view, and improved ergonomics and dexterity offered by robotic platforms, might facilitate the uptake of minimally invasive procedures. Image guidance to complement robotically assisted procedures, through the concepts of augmented reality, could well represent a major revolution to increase safety and deal with difficulties associated with the new minimally invasive approaches. © 2015 BJS Society Ltd. Published by John Wiley & Sons Ltd.

  20. Significant differences in incubation times in sheep infected with bovine spongiform encephalopathy result from variation at codon 141 in the PRNP gene.

    Science.gov (United States)

    Tan, Boon Chin; Blanco, Anthony R Alejo; Houston, E Fiona; Stewart, Paula; Goldmann, Wilfred; Gill, Andrew C; de Wolf, Christopher; Manson, Jean C; McCutcheon, Sandra

    2012-12-01

    The susceptibility of sheep to prion infection is linked to variation in the PRNP gene, which encodes the prion protein. Common polymorphisms occur at codons 136, 154 and 171. Sheep which are homozygous for the A(136)R(154)Q(171) allele are the most susceptible to bovine spongiform encephalopathy (BSE). The effect of other polymorphisms on BSE susceptibility is unknown. We orally infected ARQ/ARQ Cheviot sheep with equal amounts of BSE brain homogenate and a range of incubation periods was observed. When we segregated sheep according to the amino acid (L or F) encoded at codon 141 of the PRNP gene, the shortest incubation period was observed in LL(141) sheep, whilst incubation periods in FF(141) and LF(141) sheep were significantly longer. No statistically significant differences existed in the expression of total prion protein or the disease-associated isoform in BSE-infected sheep within each genotype subgroup. This suggested that the amino acid encoded at codon 141 probably affects incubation times through direct effects on protein misfolding rates.

  1. FACTORS ASSOCIATED WITH INFECTIONS IN SPINAL SURGERY

    Directory of Open Access Journals (Sweden)

    ANA MARÍA MORALES LÓPEZ

    Full Text Available ABSTRACT Objective: To identify the factors associated with postoperative infections in spinal surgery. Methods: Descriptive, retrospective, cross-sectional study conducted in the spine surgery department of the Medical Unit of High Specialty (UMAE at the Hospital of Traumatology and Orthopedics Lomas Verdes, Mexican Institute of Social Security (IMSS between January 01, 2013 and June 30, 2014 through medical records of the service and the records of clinical care. Data were gathered in accordance with the records of patients with infection after spinal surgery. The factors considered were age group, etiologic agent, surgical site, type of treatment, bleeding volume and pharmacotherapy. Frequency and descriptive statistic was conducted. The rank sum test with the Wilcoxon test for a single sample was performed in different measurements; Pearson's correlation was calculated and all p<0.05 values were considered significant. Results: The sample was composed of 14 patients of which 11 were female (78.6% and 3 male (21.4% with predominance of surgical area in the lumbar and dorsolumbar region. There was a significant correlation between the surgical time and the amount of bleeding with p<0.001. Conclusions: It was clear that the infections present in patients after spinal surgery are multifactorial. However, in this study the correlation between time of surgery and bleeding amount had the highest importance and relevance.

  2. Significant differe nces in demographic, clinical, and pathological features in relation to smoking and alcohol consumption among 1,633 head and neck cancer patients

    Directory of Open Access Journals (Sweden)

    Raquel Ajub Moyses

    2013-06-01

    Full Text Available OBJECTIVE: As a lifestyle-related disease, social and cultural disparities may influence the features of squamous cell carcinoma of the head and neck in different geographic regions. We describe demographic, clinical, and pathological aspects of squamous cell carcinoma of the head and neck according to the smoking and alcohol consumption habits of patients in a Brazilian cohort. METHODS: We prospectively analyzed the smoking and alcohol consumption habits of 1,633 patients enrolled in five São Paulo hospitals that participated in the Brazilian Head and Neck Genome Project - Gencapo. RESULTS: The patients who smoked and drank were younger, and those who smoked were leaner than the other patients, regardless of alcohol consumption. The non-smokers/non-drinkers were typically elderly white females who had more differentiated oral cavity cancers and fewer first-degree relatives who smoked. The patients who drank presented significantly more frequent nodal metastasis, and those who smoked presented less-differentiated tumors. CONCLUSIONS: The patients with squamous cell carcinoma of the head and neck demonstrated demographic, clinical, and pathological features that were markedly different according to their smoking and drinking habits. A subset of elderly females who had oral cavity cancer and had never smoked or consumed alcohol was notable. Alcohol consumption seemed to be related to nodal metastasis, whereas smoking correlated with the degree of differentiation.

  3. Compositional Similarities and Differences between Transparent Exopolymer Particles (TEP) from two Marine Bacteria and two Marine Algae: Significance to Surface Biofouling

    KAUST Repository

    Li, Sheng

    2015-06-12

    Transparent-exopolymer-particles (TEP) have been recently identified as a significant contributor to surface biofouling, such as on reverse osmosis (RO) membranes. TEP research has mainly focused on algal TEP/TEP precursors while limited investigations have been conducted on those released by bacteria. In this study, TEP/TEP precursors derived from both algae and bacteria were isolated and then characterized to investigate their similarities and/or differences using various advanced analytical techniques, thus providing a better understanding of their potential effect on biofouling. Bacterial TEP/TEP precursors were isolated from two species of marine bacteria (Pseudidiomarina homiensis and Pseudoalteromonas atlantica) while algal TEP/TEP precursors were isolated from two marine algae species (Alexandrium tamarense and Chaetoceros affinis). Results indicated that both isolated bacterial and algal TEP/TEP precursors were associated with protein-like materials, and most TEP precursors were high-molecular-weight biopolymers. Furthermore all investigated algal and bacterial TEP/TEP precursors showed a lectin-like property, which can enable them to act as a chemical conditioning layer and to agglutinate bacteria. This property may enhance surface biofouling. However, both proton nuclear magnetic resonance (NMR) spectra and the nitrogen/carbon (N/C) ratios suggested that the algal TEP/TEP precursors contained much less protein content than the bacterial TEP/TEP precursors. This difference may influence their initial deposition and further development of surface biofouling.

  4. Soil biogeochemistry properties vary between two boreal forest ecosystems in Quebec: significant differences in soil carbon, available nutrients and iron and aluminium crystallinity

    Science.gov (United States)

    Bastianelli, Carole; Ali, Adam A.; Beguin, Julien; Bergeron, Yves; Grondin, Pierre; Hély, Christelle; Paré, David

    2017-04-01

    At the northernmost extent of the managed forest in Quebec, the boreal forest is currently undergoing an ecological transition from closed-canopy black spruce-moss forests towards open-canopy lichen woodlands, which spread southward. Our study aim was to determine whether this shift could impact soil properties on top of its repercussions on forest productivity or carbon storage. We studied the soil biogeochemical composition of three pedological layers in moss forests (MF) and lichen woodlands (LW) north of the Manicouagan crater in Quebec. The humus layer (FH horizons) was significantly thicker and held more carbon, nitrogen and exchangeable Ca and Mg in MF plots than in LW plots. When considering mineral horizons, we found that the deep C horizon had a very close composition in both ecosystem plots, suggesting that the parent material was of similar geochemical nature. This was expected as all selected sites developed from glacial deposit. Multivariate analysis of surficial mineral B horizon showed however that LW B horizon displayed higher concentrations of Al and Fe oxides than MF B horizon, particularly for inorganic amorphous forms. Conversely, main exchangeable base cations (Ca, Mg) were higher in B horizon of MF than that of LW. Ecosystem types explained much of the variations in the B horizon geochemical composition. We thus suggest that the differences observed in the geochemical composition of the B horizon have a biological origin rather than a mineralogical origin. We also showed that total net stocks of carbon stored in MF soils were three times higher than in LW soils (FH + B horizons, roots apart). Altogether, we suggest that variations in soil properties between MF and LW are linked to a cascade of events involving the impacts of natural disturbances such as wildfires on forest regeneration that determines the of vegetation structure (stand density) and composition (ground cover type) and their subsequent consequences on soil environmental

  5. The proposed mechanism of action during different pain management techniques on expression of cytolytic molecule perforin in patients after colorectal cancer surgery.

    Science.gov (United States)

    Golubovic, S; Golubovic, V; Sotosek-Tokmadzic, V; Sustic, A; Petkovic, M; Bacic, D; Mrakovcic-Sutic, I

    2011-03-01

    The postoperative period is accompanied with neuroendocrine, metabolic and immune alteration which is caused by tissue damage, anesthesia, postoperative pain and psychological stress. Postoperative pain contributes to dysfunction of immune response as a result of interaction between central nervous and immune system. The postoperatively activated hypotalamo-pituitary-adrenocortical axis, sympathic and parasympathic nerve systems are important modulators of immune response. According to bidirectional communication of immune and nervous system, appropriate postoperative pain management could affect immune response in postoperative period. Although the postoperative suppression of immune response has been reported, a very little are known about the influences of different pain management techniques on cytotoxic function of immune cells in patients with colorectal cancer in early postoperative period. Perforin is a cytotoxic molecule expressed by activated lymphocytes which has a crucial role in elimination of tumor cells and virus-infected cells, mostly during the effector's phase of immune response. Immune compromise during the postoperative period could affect the healing processes, incidence of postoperative infections and rate and size of tumor metastases disseminated during operation. The pharmacological management of postoperative pain in patients with malignancies uses very different analgesic techniques whose possible influence on cytotoxic functions of immune cells are still understood poor. For decades the most common way of treating postoperative pain after colorectal cancer surgery was intravenous analgesia with opiods. In the last decade many investigations pointed out that opiods can also contribute to postoperative suppression of immune response. Epidural analgesia is a regional anesthesia technique that acts directly on the origin of pain impulses and pain relief can be achieved with small doses of opiods combined with local anesthetics. Local

  6. [Geriatric surgery].

    Science.gov (United States)

    Paulino-Netto, Augusto

    2005-10-01

    Modern medicine, which is evidence-based and overly scientific, has forgotten its artistic component, which is very important for surgery in general and for geriatric surgery in particular. The surgeon treating an old patient must be a politician more than a technician, more an artist than a scientist. Like Leonardo da Vinci, he or she must use scientific knowledge with intelligence and sensitivity, transforming the elderly patient's last days of life into a beautiful and harmonious painting and not into something like an atomic power station which, while no doubt useful, is deprived of beauty and sometimes very dangerous.

  7. Comparisons of different methods of anesthesia and analgesia on the levels of glycometabolism rate-limiting enzymes in erythrocytes and plasma glucose and stress hormones in patients undergoing esophagus surgery

    Institute of Scientific and Technical Information of China (English)

    Xiaokun Zhan; Xiongxiong Pan; Yinbin Pan; Jie Sun; Yanning Qian

    2008-01-01

    Objective: To compare the effects of different methods of anesthesia and analgesia on the activities of phosphofmctokinase(PFK), glucose-6-phosphate dehydrogenase(G-tPD) and aldose reductase(AR) in erythrocytes and levels of plasma glucose and stress hormones in patients undergoing esophagus surgery. Methods: Sixty-two patients scheduled for esophagus surgery were randomly divided into three groups: group I (n = 20) receiving only general anesthesia(GA) followed by intravenous patient controlled analgesia(PCA) with fentanyl 15 μg/kg. The other two groups receiving both general anesthesia combined with thoracic epidural anesthesia (GEA) and either intravenous PCA with fentanyl 15 μg/kg (group Ⅱ, n = 21) or thoracic epidurai analgesia(TEA) with 0.125% ropivaeaine and 0.0002% fentanyl mixture(group Ⅲ, n = 21) after the operation. Venous blood samples were collected for measurements of PFK, G-tPD and AR activities in erythrocytes and plasma glucose, conisol, epinephrine and norepinephrine before induction (T,1), 60 rain following the incision (T,2), 60 min(T,3) after operation, on the lst(T,4) and 2nd postoperative day(T5). Results: The activities of PFK decreased(P<0.01 or P=0.004) and the activities of G-tPD and AR increased(P<0.01) in groups Ⅰ and Ⅱ on T,4 compared with those on T,1. Between the two groups, the activities of these enzymes in group Ⅱ changed less than those of group Ⅰ (P<0.01 or P<0.05). These enzymes activities changed slightly in group Ⅲ on T,4(P>0.05). There were significant differences between group Ⅲ and the other two groups(P<0.01 or P<0.05). The levels of plasma glucose increased significantly on T,2(P<0.01), reached peak values on T,4(P<0.01) and fell on T,5 in the three groups. Compared to those of groups Ⅰ and Ⅱ, the values of plasma glucose in group Ⅲ were lower on T,4 and T,5(P<0.05 or P<0.01). The cortisol concentration in each group increased significantly at T,2(P<0.01 or P<0.05), and

  8. The change of corneal astigmatism after cataract surgery with different locations of clear corneal incision%非球面和球面人工晶状体植入术后视功能观察

    Institute of Scientific and Technical Information of China (English)

    吴智敏; 徐国旭

    2011-01-01

    Objective To analyze the corneal astigmatism before cataract surgery and evaluate the astigmatism changes after cataract surgery performed using clear corneal incisions with different locations. Methods This randomized prospective clinical study comprised 295 eyes of 218 patients underwent phacoemulsification and implantation of foldable intraocular lens through a corneal tunnel incision. Patients were randomly divided into three groups depending on the different locations of the incision: temporal, superotemporal and superior. Corneal topography was performed preoperatively and 1week, 1 month, and 3 months postoperatively. Surgically induced changes were calculated by vector analyses using the Holladay-Cravy-Koch method. Results Preoperatively, in 60.68% of eyes, corneal astigmatism was between 0.5 and 1.5 diopters (D) and in 11.86%, it was 1.5 D or higher. Meanwhile,about 29.49 percent of eyes had with-the-rule (WTR) astigmatism, while 51.19% had against-the-rule (ATR) astigmatism, and the others had oblique astigmatism. At three follow-up visits postoperatively,the mean magnitude of surgically-induced astigmatism (SIA) was lowest in the temporal incision group and highest- in the superior incision group. In addition, an ATR shift was found in the superior incision group. Conclusions Corneal astigmatism less than 1.5 D is present in most cataract surgery candidates. Cataract surgery using temporal clear corneal incision induces significantly less SIA in the early postoperative period. Superior incision may lead to an ATR astigmatism shift.%目的 观察非球面人工晶状体和球面人工晶状体植入术后视功能的变化.方法 收集行超声乳化联合IOL植入术的年龄相关性白内障患者85例96只眼,其中植入非球面(Alcon SN60WF)IOL48只眼,植入球面(Alcon SN60AT)IOL48只眼,所有病例术后裸眼视力均>0.1,术后6个月对色觉、对比敏感度、表观调节力等视功能检查.结果 术后6个月Alcon SN60WF和SN60AT

  9. Clinical effect on women with different types of endometriosis related infertility treated by conservative surgery%不同类型内异症合并不孕患者保守性手术疗效分析

    Institute of Scientific and Technical Information of China (English)

    薛晴; 曾诚; 徐阳; 尚(); 张蕾; 朱赛楠; 左文莉; 周应芳

    2013-01-01

    Objective To study pregnancy outcome and recurrence in patients with different type of endometriosi\ts related infertility treated by conservative surgery.Methods From January 2005 to December 2010,79 patients with endometriosis related infertility underwent conservative laparoscopic surgery in Peking University First Hospital,including 16 cases with deep infiltrating endometriosis,39 cases with ovarian endometriosis and 24 cases with peritoneal endometriosis.At 1 to 5 years follow-up after surgery,natural pregnancy outcome and recurrence were studied.Results (1) The accumulated pregnancy rate were 6/16 in deep infiltrating endometriosis group,36% (14/39) in ovarian endometriosis group,and 46% (11/24)in peritoneal endometriosis group,which did not reached statistical difference(P >0.05).(2) The median interval between pregnancy and surgery were 38.5 months in deep infiltrating endometriosis group,9.5 in ovarian endometriosis group and 6.0 months in peritoneal endometriosis group.The median interval in deep infiltrating endometriosis was significantly longer than that in peritoneal endometriosis group and ovarian endometriosis group (P < 0.01).Total of 11 patients in peritoneal endometriosis group and 11 patients in ovarian endometriosis group acquired pregnancy at 18 months after surgery.(3)The recurrent rate were 5/16 in deep infiltrating endometriosis group,13% (5/39) in ovarian endometriosis group and 4% (1/24)peritoneal endometriosis group,respectively(P > 0.05).Conclusions There was no difference among these three groups in accumulated pregnancy rate.However,the interval between pregnancy and surgery was significantly longer in patients with deep infiltrating endometriosis when compared with those in the other groups.%目的 探讨不同类型内异症合并不孕患者腹腔镜保守性手术后的妊娠结局及复发情况.方法 选择2005年1月至2010年12月在北京大学第一医院住院、有生育要求的内异症合并不孕患者79

  10. The biological difference between CD13+CD133+ and CD13¬CD133¬liver cancer cells and its clinical significance

    Directory of Open Access Journals (Sweden)

    Shi-long JIN

    2013-09-01

    Full Text Available Objective To compare the biological difference between CD13+CD133+ and CD13-CD133- hepatocellular carcinoma (HCC cells in HuH7 cell line and its clinical significance. Methods The status of proliferation, phase of the cell cycle, tumor formation in vivo, differentiation, and their chemoresistance to 5-FU and pirarubicin of CD13+CD133+ and CD13-CD133-HCC cells were studied to analyze the clinical implication of CD13+CD133+HCC cell subset. Results The proliferation rate of CD13+CD133+HCC cells was significantly higher than that of CD13-CD133-HCC cells. The cell-cycle phase study showed that 78.45% of the CD13+CD133+HCC cells were in the G0/G1 phase, 2.19% in G2/M phase, and 19.36% in S phase, while 62.18% CD13-CD133-HCC cells were in the G0/G1 phase, 11.88% in G2/M phase, and 25.95% in S phase. Limiting dilution analysis of HuH7 cells revealed that 1×103 CD13+CD133+ cells could form the tumor, while 1×105 CD13-CD133- cells did. CD13+CD133+ cells showed chemoresistance to 5-FU and pirarubicin, while other three subsets succumbed to the drugs. Conclusion CD13+CD133+ cancer cells in HuH7 showed the characteristics of cancer stem cells (CSCs, which might contribute to the relapse and metastasis of liver cancer, and they may be the main target for chemotherapy in human liver cancer.

  11. Spore test parameters matter: Mesophilic and thermophilic spore counts detected in raw milk and dairy powders differ significantly by test method.

    Science.gov (United States)

    Kent, D J; Chauhan, K; Boor, K J; Wiedmann, M; Martin, N H

    2016-07-01

    United States dairy industry exports have steadily risen in importance over the last 10yr, with dairy powders playing a particularly critical role. Currently, approximately half of US-produced nonfat dry milk and skim milk powder is exported. Reaching new and expanding existing export markets relies in part on the control of endospore-forming bacteria in dairy powders. This study reports baseline mesophilic and thermophilic spore counts and spore populations from 55 raw material samples (primarily raw milk) and 33 dairy powder samples from dairy powder processors across the United States. Samples were evaluated using various spore testing methodologies and included initial heat treatments of (1) 80°C for 12 min; (2) 100°C for 30 min; and (3) 106°C for 30 min. Results indicate that significant differences in both the level and population of spores were found for both raw milk and dairy powders with the various testing methods. Additionally, on average, spore counts were not found to increase significantly from the beginning to the end of dairy powder processing, most likely related to the absence of biofilm formation by processing plant-associated sporeformers (e.g., Anoxybacillus sp.) in the facilities sampled. Finally, in agreement with other studies, Bacillus licheniformis was found to be the most prevalent sporeformer in both raw materials and dairy powders, highlighting the importance of this organism in developing strategies for control and reduction of spore counts in dairy powders. Overall, this study emphasizes the need for standardization of spore enumeration methodologies in the dairy powder industry.

  12. The clinicopathological significance and ethnic difference of FHIT hypermethylation in non-small-cell lung carcinoma: a meta-analysis and literature review.

    Science.gov (United States)

    Wu, Xiaoyu; Wu, Guannan; Yao, Xuequan; Hou, Gang; Jiang, Feng

    2016-01-01

    Emerging evidence indicates that FHIT is a candidate tumor suppressor in many types of tumors including non-small-cell lung carcinoma (NSCLC). However, the prognostic value and correlation between FHIT hypermethylation and clinicopathological characteristics of NSCLC remains unclear. In this report, we performed a meta-analysis to evaluate the effects of FHIT hypermethylation on the incidence of NSCLC and clinicopathological characteristics of human NSCLC patients. Final analysis of 1,801 NSCLC patients from 18 eligible studies was performed. FHIT hypermethylation was found to be significantly higher in NSCLC than in normal lung tissue. The pooled odds ratio (OR) from ten studies included 819 NSCLC and 792 normal lung tissues (OR =7.51, 95% confidence interval [CI] =2.98-18.91, P<0.0001). Subgroup analysis based on ethnicity implied that FHIT hypermethylation level was higher in NSCLC tissues than in normal tissues in both Caucasians (P=0.02) and Asians (P<0.0001), indicating that the difference in Asians was much more significant. FHIT hypermethylation was also correlated with sex status, smoking status, as well as pathological types. In addition, patients with FHIT hypermethylation had a lower survival rate than those without (hazard ratio =1.73, 95% CI =1.10-2.71, P=0.02). The results of this meta-analysis suggest that FHIT hypermethylation is associated with an increased risk and poor survival in NSCLC patients. FHIT hypermethylation, which induces the inactivation of FHIT gene, plays an important role in the carcinogenesis and clinical outcome and may serve as a potential diagnostic marker and drug target of NSCLC.

  13. Characterization of TiN, TiC and Ti(C,N) in titanium-alloyed ferritic chromium steels focusing on the significance of different particle morphologies

    Energy Technology Data Exchange (ETDEWEB)

    Michelic, S.K., E-mail: susanne.michelic@unileoben.ac.at [Chair of Ferrous Metallurgy, Montanuniversitaet Leoben, Franz-Josef-Straße 18, 8700 Leoben (Austria); Loder, D. [Chair of Ferrous Metallurgy, Montanuniversitaet Leoben, Franz-Josef-Straße 18, 8700 Leoben (Austria); Reip, T.; Ardehali Barani, A. [Outokumpu Nirosta GmbH, Essener Straße 244, 44793 Bochum (Germany); Bernhard, C. [Chair of Ferrous Metallurgy, Montanuniversitaet Leoben, Franz-Josef-Straße 18, 8700 Leoben (Austria)

    2015-02-15

    Titanium-alloyed ferritic chromium steels are a competitive option to classical austenitic stainless steels owing to their similar corrosion resistance. The addition of titanium significantly influences their final steel cleanliness. The present contribution focuses on the detailed metallographic characterization of titanium nitrides, titanium carbides and titanium carbonitrides with regard to their size, morphology and composition. The methods used are manual and automated Scanning Electron Microscopy with Energy Dispersive X-ray Spectroscopy as well as optical microscopy. Additional thermodynamic calculations are performed to explain the precipitation procedure of the analyzed titanium nitrides. The analyses showed that homogeneous nucleation is decisive at an early process stage after the addition of titanium. Heterogeneous nucleation gets crucial with ongoing process time and essentially influences the final inclusion size of titanium nitrides. A detailed investigation of the nuclei for heterogeneous nucleation with automated Scanning Electron Microscopy proved to be difficult due to their small size. Manual Scanning Electron Microscopy and optical microscopy have to be applied. Furthermore, it was found that during solidification an additional layer around an existing titanium nitride can be formed which changes the final inclusion morphology significantly. These layers are also characterized in detail. Based on these different inclusion morphologies, in combination with thermodynamic results, tendencies regarding the formation and modification time of titanium containing inclusions in ferritic chromium steels are derived. - Graphical abstract: Display Omitted - Highlights: • The formation and modification of TiN in the steel 1.4520 was examined. • Heterogeneous nucleation essentially influences the final steel cleanliness. • In most cases heterogeneous nuclei in TiN inclusions are magnesium based. • Particle morphology provides important information

  14. Short- and long-term outcomes of laparoscopic surgery vs open surgery for transverse colon cancer: a retrospective multicenter study

    Directory of Open Access Journals (Sweden)

    Kim JW

    2016-04-01

    Full Text Available Jong Wan Kim,1 Jeong Yeon Kim,1 Byung Mo Kang,2 Bong Hwa Lee,3 Byung Chun Kim,4 Jun Ho Park5 1Department of Surgery, Dongtan Sacred Heart Hospital, College of Medicine, Hallym University, Hwaseong Si, 2Department of Surgery, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon Si, 3Department of Surgery, Hallym Sacred Heart Hospital, College of Medicine, Hallym University, Anyang Si, 4Department of Surgery, Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, 5Department of Surgery, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Republic of Korea Purpose: The purpose of the present study was to compare the perioperative and oncologic outcomes between laparoscopic surgery and open surgery for transverse colon cancer.Patients and methods: We conducted a retrospective review of patients who underwent surgery for transverse colon cancer at six Hallym University-affiliated hospitals between January 2005 and June 2015. The perioperative outcomes and oncologic outcomes were compared between laparoscopic and open surgery.Results: Of 226 patients with transverse colon cancer, 103 underwent laparoscopic surgery and 123 underwent open surgery. There were no differences in the patient characteristics between the two groups. Regarding perioperative outcomes, the operation time was significantly longer in the laparoscopic group than in the open group (267.3 vs 172.7 minutes, P<0.001, but the time to soft food intake (6.0 vs 6.6 days, P=0.036 and the postoperative hospital stay (13.7 vs 15.7 days, P=0.018 were shorter in the laparoscopic group. The number of harvested lymph nodes was lower in the laparoscopic group than in the open group (20.3 vs 24.3, P<0.001. The 5-year overall survival (90.8% vs 88.6%, P=0.540 and disease-free survival (86.1% vs 78.9%, P=0.201 rates were similar in both groups.Conclusion: The present study showed that laparoscopic surgery is associated

  15. Cross-national differences in clinically significant cannabis problems: epidemiologic evidence from 'cannabis-only' smokers in the United States, Mexico, and Colombia

    Directory of Open Access Journals (Sweden)

    Posada-Villa Jose

    2010-03-01

    Full Text Available Abstract Background Epidemiological studies show wide variability in the occurrence of cannabis smoking and related disorders across countries. This study aims to estimate cross-national variation in cannabis users' experience of clinically significant cannabis-related problems in three countries of the Americas, with a focus on cannabis users who may have tried alcohol or tobacco, but who have not used cocaine, heroin, LSD, or other internationally regulated drugs. Methods Data are from the World Mental Health Surveys Initiative and the National Latino and Asian American Study, with probability samples in Mexico (n = 4426, Colombia (n = 5,782 and the United States (USA; n = 8,228. The samples included 212 'cannabis only' users in Mexico, 260 in Colombia and 1,724 in the USA. Conditional GLM with GEE and 'exact' methods were used to estimate variation in the occurrence of clinically significant problems in cannabis only (CO users across these surveyed populations. Results The experience of cannabis-related problems was quite infrequent among CO users in these countries, with weighted frequencies ranging from 1% to 5% across survey populations, and with no appreciable cross-national variation in general. CO users in Colombia proved to be an exception. As compared to CO users in the USA, the Colombia smokers were more likely to have experienced cannabis-associated 'social problems' (odds ratio, OR = 3.0; 95% CI = 1.4, 6.3; p = 0.004 and 'legal problems' (OR = 9.7; 95% CI = 2.7, 35.2; p = 0.001. Conclusions This study's most remarkable finding may be the similarity in occurrence of cannabis-related problems in this cross-national comparison within the Americas. Wide cross-national variations in estimated population-level cumulative incidence of cannabis use disorders may be traced to large differences in cannabis smoking prevalence, rather than qualitative differences in cannabis experiences. More research is needed to identify conditions that

  16. Cross-national differences in clinically significant cannabis problems: epidemiologic evidence from 'cannabis-only' smokers in the United States, Mexico, and Colombia.

    Science.gov (United States)

    Fiestas, Fabian; Radovanovic, Mirjana; Martins, Silvia S; Medina-Mora, Maria E; Posada-Villa, Jose; Anthony, James C

    2010-03-23

    Epidemiological studies show wide variability in the occurrence of cannabis smoking and related disorders across countries. This study aims to estimate cross-national variation in cannabis users' experience of clinically significant cannabis-related problems in three countries of the Americas, with a focus on cannabis users who may have tried alcohol or tobacco, but who have not used cocaine, heroin, LSD, or other internationally regulated drugs. Data are from the World Mental Health Surveys Initiative and the National Latino and Asian American Study, with probability samples in Mexico (n = 4426), Colombia (n = 5,782) and the United States (USA; n = 8,228). The samples included 212 'cannabis only' users in Mexico, 260 in Colombia and 1,724 in the USA. Conditional GLM with GEE and 'exact' methods were used to estimate variation in the occurrence of clinically significant problems in cannabis only (CO) users across these surveyed populations. The experience of cannabis-related problems was quite infrequent among CO users in these countries, with weighted frequencies ranging from 1% to 5% across survey populations, and with no appreciable cross-national variation in general. CO users in Colombia proved to be an exception. As compared to CO users in the USA, the Colombia smokers were more likely to have experienced cannabis-associated 'social problems' (odds ratio, OR = 3.0; 95% CI = 1.4, 6.3; p = 0.004) and 'legal problems' (OR = 9.7; 95% CI = 2.7, 35.2; p = 0.001). This study's most remarkable finding may be the similarity in occurrence of cannabis-related problems in this cross-national comparison within the Americas. Wide cross-national variations in estimated population-level cumulative incidence of cannabis use disorders may be traced to large differences in cannabis smoking prevalence, rather than qualitative differences in cannabis experiences. More research is needed to identify conditions that might make cannabis-related social and legal problems more

  17. 术后镇痛对冠心病患者围术期心肌损伤的影响%Effects of Postoperative Different Analgesia Styles on Perioperative Myocardial Injury in Coronary Heart Disease Patients Undergoing Thoracic Surgery

    Institute of Scientific and Technical Information of China (English)

    严丽萍; 吴明慧; 陈丽; 王莹

    2011-01-01

    Objective To compare the effects of postoperative different analgesia on the myocardial injury in coronary heart disease patients undergoing thoracic surgery, and to offer a theoretical foundation for better analgesia. Methods Fouty patients, ASA Ⅱ - Ⅲ ,undergoing thoracic surgery under general anesthesia combined with epidural block were randomly allocated to patientcontrolled intravenous analgesia(PCIA) group( n = 20) and patient-controlled epidural analgesia( PCEA ) group( n = 20 ). Blood samples were prepared for the measurement of cTnI. The ST segment changes were recorded. The analgesia effect was assessed using visual analog scores(VAS). Results The values of cTnI in PECA group were significant lower than those in group PICA ( P <0.05 ). The total leads of depression of ST segment (NST) and sum of depression of ST segment( Σ ST) in PECA group were fewer than those in group PICA at different time points (P < O. 05). Conclusion Compared with group PICA, PECA gets a better analgesia and may significantly protect the myocardial.%目的 比较不同镇痛方法对胸科冠心病患者围术期心肌损伤的影响,为胸科冠心病患者选择适宜的术后镇痛方式.方法 择期行胸科手术的冠心病患者40例,ASAⅡ~Ⅲ级,随机分为静脉自控镇痛组(HCA组),硬膜外自控镇痛组(PECA组),每组20例.两组患者均在全麻复合硬膜外阻滞下手术,术毕分别接PICA和PECA.观察两组患者在围术期血清肌钙蛋白Ⅰ(cTnI)浓度及心电图ST段变化,用视觉模拟评估法评估镇痛效果(VSA评分).结果 两组患者术毕血浆cTnI浓度PECA组比PICA组的浓度明显降低(P<0.05).术后各时点心电图ST段改变导联数(NST)和ST段压低幅度的总和(∑ST)PECA组明显比PICA组减少(P<0.05).结论 胸科冠心病患者术后使用PECA镇痛对防治心肌受损有一定的保护作用.

  18. GENERAL SURGERY

    African Journals Online (AJOL)

    Globally, the entry of female students into medical schools has ... how female registrars perceived the impact of gender on their training and practice of surgery. ... male-dominated specialty, their choice of mentors and the challenges that they encountered ..... Social Determinants of Health2007 (Accessed on 23 Sep 2016).

  19. Robotic Surgery in Gynecologic Oncology

    Directory of Open Access Journals (Sweden)

    Robert DeBernardo

    2011-01-01

    Full Text Available Robotic surgery for the management of gynecologic cancers allows for minimally invasive surgical removal of cancer-bearing organs and tissues using sophisticated surgeon-manipulated, robotic surgical instrumentation. Early on, gynecologic oncologists recognized that minimally invasive surgery was associated with less surgical morbidity and that it shortened postoperative recovery. Now, robotic surgery represents an effective alternative to conventional laparotomy. Since its widespread adoption, minimally invasive surgery has become an option not only for the morbidly obese but for women with gynecologic malignancy where conventional laparotomy has been associated with significant morbidity. As such, this paper considers indications for robotic surgery, reflects on outcomes from initial robotic surgical outcomes data, reviews cost efficacy and implications in surgical training, and discusses new roles for robotic surgery in gynecologic cancer management.

  20. Viscoless microincision cataract surgery

    Directory of Open Access Journals (Sweden)

    Guy Sallet

    2008-06-01

    Full Text Available Guy SalletDepartment of Opthamology, Aalsters Stedelijk Ziekenhuis, BelgiumAbstract: A cataract surgery technique is described in which incisions, continuous circular capsulorhexis and hydrodissection are made without the use of any viscoelastics. Two small incisions are created through which the different parts of the procedure can take place, maintaining a stable anterior chamber under continuous irrigation. Subsequent bimanual phacoemulsification can be done through these microincisions. At the end of the procedure, an intraocular lens can be inserted through the self-sealing incision under continuous irrigation. 50 consecutive cataract patients were operated on without the use of viscoelastics and then compared with a group of 50 patients who had been helped with viscoelastics. No difference in outcome, endothelial cell count or pachymetry was noted between the two groups. No intraoperative complication was encountered. Viscoless cataract surgery was a safe procedure with potential advantages.Keywords: ophthalmic visco-surgical device, viscoless cataract surgery, microincision

  1. The temporoammonic input to the hippocampal CA1 region displays distinctly different synaptic plasticity compared to the Schaffer collateral input in vivo: significance for synaptic information processing

    Science.gov (United States)

    Aksoy-Aksel, Ayla; Manahan-Vaughan, Denise

    2013-01-01

    In terms of its sub-regional differentiation, the hippocampal CA1 region receives cortical information directly via the perforant (temporoammonic) path (pp-CA1 synapse) and indirectly via the tri-synaptic pathway where the last relay station is the Schaffer collateral-CA1 synapse (Sc-CA1 synapse). Research to date on pp-CA1 synapses has been conducted predominantly in vitro and never in awake animals, but these studies hint that information processing at this synapse might be distinct to processing at the Sc-CA1 synapse. Here, we characterized synaptic properties and synaptic plasticity at the pp-CA1 synapse of freely behaving adult rats. We observed that field excitatory postsynaptic potentials at the pp-CA1 synapse have longer onset latencies and a shorter time-to-peak compared to the Sc-CA1 synapse. LTP (>24 h) was successfully evoked by tetanic afferent stimulation of pp-CA1 synapses. Low frequency stimulation evoked synaptic depression at Sc-CA1 synapses, but did not elicit LTD at pp-CA1 synapses unless the Schaffer collateral afferents to the CA1 region had been severed. Paired-pulse responses also showed significant differences. Our data suggest that synaptic plasticity at the pp-CA1 synapse is distinct from the Sc-CA1 synapse and that this may reflect its specific role in hippocampal information processing. PMID:23986697

  2. The temporoammonic input to the hippocampal CA1 region displays distinctly different synaptic plasticity compared to the Schaffer collateral input in vivo: significance for synaptic information processing

    Directory of Open Access Journals (Sweden)

    Ayla eAksoy Aksel

    2013-08-01

    Full Text Available In terms of its sub-regional differentiation, the hippocampal CA1 region receives cortical information directly via the perforant (temporoammonic path (pp-CA1 synapse and indirectly via the tri-synaptic pathway where the last relay station is the Schaffer collateral-CA1 synapse (Sc-CA1 synapse. Research to date on pp-CA1 synapses has been conducted predominantly in vitro and never in awake animals, but these studies hint that information processing at this synapse might be distinct to processing at the Sc-CA1 synapse. Here, we characterized synaptic properties and synaptic plasticity at the pp-CA1 synapse of freely behaving adult rats. We established that field excitatory postsynaptic potentials at the pp-CA1 have longer onset latencies and a shorter time-to-peak compared to the Sc-CA1 synapse. LTP (> 24h was successfully evoked by tetanic afferent stimulation of pp-CA1 synapses. Low frequency stimulation evoked synaptic depression at Sc-CA1 synapses, but did not elicit LTD at pp-CA1 synapses unless the Schaffer collateral afferents to the CA1 region had been severed. Paired-pulse responses also showed significant differences. Our data suggest that synaptic plasticity at the pp-CA1 synapse is distinct from the Sc-CA1 synapse and that this may reflect its specific role in hippocampal information processing.

  3. Significant interethnic differencies in functional variants of PON1 and P2RY12 genes in Roma and Hungarian population samples.

    Science.gov (United States)

    Janicsek, Ingrid; Sipeky, Csilla; Bene, Judit; Duga, Balazs; Melegh, Bela I; Melegh, Bela; Sümegi, Katalin; Jaromi, Luca; Magyari, Lili; Melegh, Bela

    2015-01-01

    Antiplatelet therapy with clopidogrel is one of the most common therapies given to patients worldwide. However, the clinical efficacy and toxicity of clopidogrel is not constant in every patient due to interindividual variations. There are several factors that contribute to these interindividual differencies such as SNPs in genes of specific receptors and enzymes. PON1 (paraoxonase 1) plays an important role in the bioactivation of clopidogrel. Single nucleotide polymorphisms of this gene decrease the activity of paraoxonase enzyme and lead to an unefficient clopidogrel effect. P2RY12 (purinergic receptor P2Y, G-protein coupled, 12) gene is coding a receptor, which is situated on the surface of the platelets and plays a role in ADP-induced platelet aggregation. In this study we investigated 2 functional SNPs of PON1 gene (rs662 and rs854560) and 3 variants of the P2RY12 gene (rs2046934, rs6798347, rs6801273) in samples pooled from average Hungarian Roma and Hungarian population samples with PCR-RFLP method. For the PON1 variants we detected that the R allele frequency was significantly lower in the Roma group compared to the Hungarian population. (0.249 vs 0.318 p Roma than in Hungarians (0.332 vs 0.290 p Romas (1.4 vs 0.2 %, p Roma people that has not been reported for other populations.

  4. Diode laser surgery. Ab interno and ab externo versus conventional surgery in rabbits.

    Science.gov (United States)

    Karp, C L; Higginbotham, E J; Edward, D P; Musch, D C

    1993-10-01

    Fibroblastic proliferation of subconjunctival tissues remains a primary mechanism of failure in filtration surgery. Minimizing the surgical manipulation of episcleral tissues may reduce scarring. Laser sclerostomy surgery involves minimal tissue dissection, and is gaining attention as a method of potentially improving filter duration in high-risk cases. Twenty-five New Zealand rabbits underwent filtration surgery in one eye, and the fellow eye remained as the unoperated control. Ten rabbits underwent ab externo diode laser sclerostomy surgery, ten underwent ab interno diode sclerostomy surgery, and five had posterior sclerostomy procedures. Filtration failure was defined as a less-than-4-mmHg intraocular pressure (IOP) difference between the operative and control eyes. The mean time to failure for the ab externo, ab interno, and conventional posterior sclerostomy techniques measured 17.4 +/- 11.5, 13.1 +/- 6.7, and 6.0 +/- 3.1 days, respectively. In a comparison of the laser-treated groups with the conventional procedure, the time to failure was significantly longer (P = 0.02) for the ab externo filter. The mean ab interno sclerostomy duration was longer than the posterior lip procedure, but this difference was not statistically significant (P = 0.15). The overall level of IOP reduction was similar in the three groups. These data suggest that diode laser sclerostomy is a feasible technique in rabbits, and the ab externo approach resulted in longer filter duration than the conventional posterior lip procedure in this model.

  5. Nepalese patients' anxiety and concerns before surgery.

    Science.gov (United States)

    Pokharel, Krishna; Bhattarai, Balkrishna; Tripathi, Mukesh; Khatiwada, Sindhu; Subedi, Asish

    2011-08-01

    To determine the changes in anxiety level and need for information at three different time points before surgery. Prospective observational study. Ward (T(1)), preoperative holding area (T(2)), and operating room (T(3)) of a university hospital. 201 adult, ASA physical status 1 and 2 patients scheduled for elective operations. Level of anxiety and need for information about surgery and/or anesthesia were assessed with the Amsterdam Preoperative Anxiety and Information Scale (APAIS) three times before the start of surgery: in the ward, the preoperative holding area, and the operating room. The psychometric characteristics of the APAIS were similar to its original Dutch version. The frequency of patients with high preoperative anxiety peaked at the preoperative holding area. The median score on need for information decreased from T(1) [4; interquartile range (IR) 2-5] to T(2) (3; IR 2-4) (P anxiety scores for anesthesia were significantly (P information about their surgical procedure was significantly (P information also were more anxious (P anxiety were female gender [odds ratio (OR) 4; 95% confidence interval (CI) 1.09-14.94] and need for general anesthesia (OR 7.1; 95% CI 0.93-54.98). The characteristics, general anesthesia (OR 3.3; 95% CI 1.1-10.0), younger age (≤ 30 yrs; OR 2.9; 95% CI 1.3-6.4), education (>12 yrs; OR 2.6; 95% CI 1.2-5.4), and no previous surgery (OR 2.6; 95% CI 1.2-5.5), correlated with greater need for information. The frequency of anxious patients is variable at different time points before surgery. The factors correlating with anxiety before surgery are nonmodifiable. Providing information to those individuals is the only modifiable option. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. Carotid artery surgery

    Science.gov (United States)

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  7. 个性超声乳化切口并不同类型人工晶状体植入术后角膜散光和视觉质量的比较%The clinical investigation of dynamic changes of corneal astigmatism and visual quality for patients after phacoemulsification surgery through different incision and implantation of different designed intraocular lens

    Institute of Scientific and Technical Information of China (English)

    王佃科; 张杰; 王杰; 李艳; 梁山; 刘育霞

    2009-01-01

    Objective To compare the corneal astigmatism and wavefront aberration differences of patients with cataract coexisting corneal astigmatism after phacoemulsification surgery through traditional superior clear corneal incision or phacoemulsification surgery through clear corneal incision guided by corneal topography and implantation of different spherical aberration intraocular lenses (IOL). Methods In a prospective randomized sample controlled clinical trial, 90 patients (90 eyes) with age-related cataract and corneal astigmatism were randomly divided into 3 groups: (Group A) traditional superior corneal incision phacoemulsification surgery and AcrySof SN60AT IOL implantation, (Group B) corneal topography guiding incision phacoemulsification surgery and AcrySof SN60AT IOL implantation and (Group C ) corneal topography guiding incision phacoemulsification surgery and AcrySof SN60WF IOL implantation. Corneal topography tests were performed at 1 week, 1 month, 3 months and 6 months postoperatively. The Wavefront aberration was measured using a custom built Tschcming wavefront sensor--ALLEGRETTO WAVE Analyze at 90 days postoperatively. Third-, 4th-, 5th-, total and higher-order aberration (HOA) root-mean-square (RMS), spherical aberration and coma aberration were compared at virtual pupil diameters of 6 mm postoperatively. Statistical analyses were performed using the analysis of chi square test, repeated measurement data analysis of variance, one-way analysis of variance (ANOVA), and multiple comparisons Studcnts-Newman-Keuls test. Results Corneal topography tests indicated that no significant difference for corneal astigmatism was found between these three groups preoperatively( F =0. 08 ,P >0. 05). The corneal astigmatism was decomposed into J0, J45 and P with a Vector-based method, and statistically analyzed . When compared with Group B and GroupC, Group A had higher values of corneal J0 ( F = 9.54, P 0. 05 ). However groups and times had interactions ( F = 13

  8. Gender effect on vascular inflammation following bariatric surgery.

    Science.gov (United States)

    Blum, Arnon; Tamir, Snait; Hazzan, David; Podvitzky, Oxana; Sirchan, Rizak; Keinan-Boker, Lital; Ben-Shushan, Rotem Shelly; Blum, Nava; Suliman, Laylee Shaich; Geron, Nissim

    2012-01-01

    Studies have shown that mortality was reduced by 31.6% in patients that underwent bariatric surgery compared with the non-operative control group. However, in most surgical series the majority of patients were women, and men had higher post-operative mortality rates and a higher postoperative morbidity, regardless of weight. Our primary end point was to study gender effects on vascular inflammation following bariatric surgery for weight loss. Methods. A prospective study evaluated vascular inflammation in obese patients before and three months after bariatric surgery. Markers of vascular inflammation were measured - before surgery and three months afterwards. Results. One hundred and two patients (73 women and 29 men, 40.5 ± 12.3 years old) underwent bariatric surgery. Correlation was found between BMI change and waist circumference change (r = 0.658, P women; P = 0.05) and hypertension (men > women; P = 0.06). In women, following bariatric surgery, BMI was decreased (pbariatric surgery, BMI was decreased (p = 0.001) (a decrease of 8.1), waist circumference was reduced (pbariatric surgery on vascular inflammation. Bariatric surgery had no significant effect on biochemical inflammatory markers in male patients, while females undergoing the same kind of bariatric surgery for weight loss showed a significant decrease in these markers of inflammation. These results may explain the epidemiological data that described higher morbidity and mortality among obese men undergoing bariatric operation for weight loss. This is the first study that has demonstrated a gender difference in the inflammatory responses that may affect clinical outcome, and cardiovascular morbidity and mortality.

  9. Predictors of willingness to undergo elective musculoskeletal surgery

    Directory of Open Access Journals (Sweden)

    Gandhi R

    2013-03-01

    Full Text Available Rajiv Gandhi,1,2 Anthony V Perruccio,1,3 Y Raja Rampersaud1,21Division of Orthopaedic Surgery, Toronto Western Hospital, University Health Network, 2Department of Surgery, Faculty of Medicine, University of Toronto, 3Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, CanadaPurpose: Knowledge of what influences patients’ willingness to undergo elective orthopedic surgery is vital to the patient shared decision-making process. We sought to document the prevalence and identify the predictors of unwillingness to undergo surgery among a cohort of hip/knee, foot/ankle, neck/back, and hip/knee patients.Patients and methods: Patient demographics and information on patient health status, perceptions of risk and success of surgery, and willingness to undergo surgery were collected. Sequential logistic regression models were used to investigate the influence of the captured variables on willingness to undergo surgery.Results: Overall, 392 (20% of 1946 participants reported being unwilling to undergo or unsure about undergoing (“unwilling/unsure” surgery if it was offered to them. From adjusted analyses, low income and non-White ethnicity were associated with a greater likelihood of being unwilling/unsure. Compared with hip/knee patients, neck/back patients were more likely to report being unwilling/unsure (odds ratio: 1.90 [95% confidence interval: 1.36, 265]; no differences were found between the remaining anatomical groups. However, when perceptions of risk and success were additionally considered, the influence for the neck/back cohort was significantly attenuated. Foot/ankle and elbow/shoulder patients were found to be significantly less likely to report unwillingness when perceptions were considered.Conclusion: In addition to demographic/economic influences, perceptions of surgical risk and success play a critical role in patients’ willingness to undergo surgery.Keywords: risk perception, orthopedic surgery

  10. General Surgery Resident Vascular Operative Experience in the Era of Endovascular Surgery and Vascular Fellowships.

    Science.gov (United States)

    Yan, Huan; Maximus, Steven; Kim, Jerry J; Smith, Brian; Kim, Dennis; Koopmann, Matthew; DeVirgilio, Christian

    2015-10-01

    Advances in endovascular surgery have resulted in a decline in major open arterial reconstructions nationwide. Our objective is to investigate the effect of endovascular surgery on general surgery resident experience with open vascular surgery. Between 2004 and 2014, 112 residents graduated from two academic institutions in Southern California. Residents were separated into those who graduated in 2004 to 2008 (period 1) and in 2009 to 2014 (period 2). Case volumes of vascular procedures were compared using two-sample t test. A total of 43 residents were in period 1 and 59 residents were in period 2. In aggregate, there was no significant difference in open cases recorded between the two periods (84 vs 87, P = 0.194). Subgroup analysis showed period 2 recorded significantly fewer cases of open aneurysm repair (5 vs 3, P surgery residents experienced a significant decline in several index open major arterial reconstruction cases. This decline was offset by maintenance of dialysis access procedures. If the trend continues, future general surgeons will not be proficient in open vascular procedures.

  11. Pregnancy management following bariatric surgery.

    Science.gov (United States)

    Uzoma, A; Keriakos, R

    2013-02-01

    Bariatric surgery is gaining in popularity, due to globally increasing rates of obesity. In the UK, this has manifested as a 14-fold increase in bariatric surgery between 2004 and 2010, making it necessary to develop strategies to manage women who become pregnant following bariatric surgery. This review paper has explored all the current evidence in the literature and provided a comprehensive management strategy for pregnant women following bariatric surgery. The emphasis is on a multidisciplinary team approach to all aspects of care. Adequate pre-conception and antenatal and postnatal care is essential to good pregnancy outcomes with emphasis on appropriate nutritional supplementation. This is especially important following malabsorptive procedures. There is no evidence to suggest that pregnancy outcome is worse after bariatric surgery, though women who remain obese are prone to obesity-related risks in pregnancy. Neonatal outcome post-bariatric surgery is no different from the general population.

  12. Racing performance in Standardbred trotting horses with proximal palmar/plantar first phalangeal fragments relative to the timing of surgery.

    Science.gov (United States)

    Carmalt, J L; Borg, H; Näslund, H; Waldner, C

    2015-07-01

    Proximal palmar/plantar osteochondral fragmentation of the first phalanx is a frequent radiographic finding in Standardbred horses. These lesions are routinely removed prior to the onset of a racing career with no evidence to support the timing of this surgical intervention. To determine whether horses racing before surgery slowed as they approached surgery date and whether they speeded up after surgery. To investigate the factors affecting whether a horse raced after surgery and compare the performance of horses that did and did not race before surgery. A retrospective study using 193 Swedish Standardbred trotters. Medical records and radiographs of each horse were examined. Racing data were retrieved from official online records. Generalising estimating equations were used to examine presurgery racing performance and determine whether this differed between horses that raced before surgery and those that had not. Multivariable regression was used to examine career earnings and number of career races. Horses racing before surgery neither slowed as they approached surgery, nor speeded up after surgery. Race speed of horses raced before surgery was not different from those that only raced after surgery. Racing before surgery was not associated with whether horses raced following surgery. Only horses with 3 affected legs had slower race speeds than other horses. No other horse level variables affected race speed, number of career races, career earnings or top speed. There was no significant difference in race speed between horses that raced before surgery and those that did not. Horses did not slow down prior to surgery. Horses with 3 affected legs ran slower than those with only a single or 2 affected limbs. There was no association between timing of surgery and race speed or career longevity. The potential benefits of surgical intervention should be critically examined. © 2014 EVJ Ltd.

  13. Different Degrees of Muscle Relaxation Affecting Cortical Somatosensory Evoked Potential in Spine Surgery%不同肌松程度对脊柱手术皮层体感诱发电位的监测

    Institute of Scientific and Technical Information of China (English)

    李传翔; 宋伏虎; 王怡; 金大地; 陈力; 宋冬梅

    2011-01-01

    目的:了解新型肌肉松弛药顺式阿曲库铵用于脊柱外科手术,肌松程度对皮层体感诱发电位(CSEP)监测的影响.方法:选择ASAI~II级,择期脊柱外科手术病人60例,随机分为6组.在首次推注插管剂量的顺式阿曲库铵后,连续监测T1,以肌松监测反馈调控输注模式调整不同剂量进行输注,维持各分组所要求的不同肌松程度,观察6组病例术中CSEP的P40波的波幅及潜伏期.同时对肌松分级进行主观评定.结果:在不同的肌松程度下,IV组、V组及VI组患者的波幅与基准值比较有统计学差异(P< 0.05);I组、II组、III组患者的波幅与基准值比较无统计学差异(P> 0.05).肌松主观评定,V组、VI组患者肌松评价差的例数与I组、II组、III组、IV组比较有统计学差义(P< 0.05).结论:能满足CSEP监测的要求,同时也能满足手术及运动诱发电位监测需要的肌松程度是T1值在0~15%.%Objective To research novel muscle relaxation of cisatracurium used in spine surgery and to observe different degrees of muscle relaxation affecting cortical somatosensory evoked potential. Methods Sixty ASA Ⅰ or Ⅱ patients undergoing spine surgery were randomly divided into six groups (n=l0 each). After six groups at the first time to push the intubation dose with cisatracurium, continuous infusion with the feedback infusion pattern according muscle relaxation monitoring was made and different groups of muscle degree were maintained. The band and latency of P40 in motor evoked potential were observed. The subjective assessment to muscle relaxation was made at the same time. Results In different degrees of muscle relaxation, there were significant differences of the band and latency between group Ⅳ, group Ⅴ and group Ⅵ as compared with reference value. No significant difference of the band and latency among group Ⅰ, group Ⅱ and group Ⅲ compared with reference value. There were significant differences between

  14. Superior oblique surgery: when and how?

    Directory of Open Access Journals (Sweden)

    Taylan Şekeroğlu H

    2013-08-01

    Full Text Available Hande Taylan Şekeroğlu,1 Ali Sefik Sanac,1 Umut Arslan,2 Emin Cumhur Sener11Department of Ophthalmology, 2Department of Biostatistics, Hacettepe University Faculty of Medicine, Ankara, TurkeyBackground: The purpose of this paper is to review different types of superior oblique muscle surgeries, to describe the main areas in clinical practice where superior oblique surgery is required or preferred, and to discuss the preferred types of superior oblique surgery with respect to their clinical outcomes.Methods: A consecutive nonrandomized retrospective series of patients who had undergone superior oblique muscle surgery as a single procedure were enrolled in the study. The diagnosis, clinical features, preoperative and postoperative vertical deviations in primary position, type of surgery, complications, and clinical outcomes were reviewed. The primary outcome measures were the type of strabismus and the type of superior oblique muscle surgery. The secondary outcome measure was the results of the surgeries.Results: The review identified 40 (20 male, 20 female patients with a median age of 6 (2–45 years. Nineteen patients (47.5% had Brown syndrome, eleven (27.5% had fourth nerve palsy, and ten (25.0% had horizontal deviations with A pattern. The most commonly performed surgery was superior oblique tenotomy in 29 (72.5% patients followed by superior oblique tuck in eleven (27.5% patients. The amount of vertical deviation in the fourth nerve palsy and Brown syndrome groups (P = 0.01 for both and the amount of A pattern in the A pattern group were significantly reduced postoperatively (P = 0.02.Conclusion: Surgery for the superior oblique muscle requires experience and appropriate preoperative evaluation in view of its challenging nature. The main indications are Brown syndrome, fourth nerve palsy, and A pattern deviations. Superior oblique surgery may be effective in terms of pattern collapse and correction of vertical deviations in primary

  15. Secondary surgery in paediatric facial paralysis reanimation.

    Science.gov (United States)

    Terzis, Julia K; Olivares, Fatima S

    2010-11-01

    Ninety-two children, the entire series of paediatric facial reanimation by a single surgeon over thirty years, are presented. The objective is to analyse the incidence and value of secondary revisions for functional and aesthetic refinements following the two main stages of reanimation. The reconstructive strategy varied according to the denervation time, the aetiology, and whether the paralysis was uni- or bilateral, complete or partial. Irrespective of these variables, 89% of the patients required secondary surgery. Post-operative videos were available in seventy-two cases. Four independent observers graded patients' videos using a scale from poor to excellent. The effect of diverse secondary procedures was measured computing a mean-percent-gain score. Statistical differences between treatment groups means were tested by the t-test and one-way ANOVA. Two-thirds of the corrective and ancillary techniques utilized granted significantly higher mean-scores post-secondary surgery. A comparison of pre- and post-operative data found valuable improvements in all three facial zones after secondary surgery. In conclusion, inherent to dynamic procedures is the need for secondary revisions. Secondary surgery builds in the potential of reanimation surgery, effectively augmenting functional faculties and aesthesis.

  16. Harmonic dissection versus electrocautery in breast surgery in regional Victoria.

    Science.gov (United States)

    Kiyingi, Andrew K; Macdonald, Leigh J; Shugg, Sarah A; Bollard, Ruth C

    2015-05-01

    Harmonic instruments are an alternative tool for surgical dissection. The aim of this study is to evaluate differences in clinical outcomes relating to harmonic dissection when compared with electrocautery in patients undergoing major breast surgery in a regional centre over a 3-year period. Retrospective chart analysis was conducted of 52 patients undergoing major breast surgery for carcinoma or ductal carcinoma in situ by a single surgeon in a regional centre from May 2008 to January 2011. Analysis involved the extraction of qualitative data relating to patient demographics, surgery type and specimen histopathology. Quantitative data were extracted relating to duration of surgery, duration of patient-controlled analgesia (PCA) use, length of hospital admission, drainage output and presence of infection, haematoma or seroma. Fifty-two patients underwent major breast surgery; harmonic dissection n = 32 and electrocautery n = 20. The two groups were comparable. There was no significant difference identified relating the outcome measures. The median operative duration was shorter in the harmonic dissection group, however, was not of statistical significance. No significant difference was identified between groups relating to length of inpatient stay, duration of PCA use and total volume wound drainage and total days of drainage. Incidence of seroma and infection in the groups was not significantly different. The harmonic dissection is safe and effective in major breast surgery. The study did not demonstrate any clinical advantage from the use of harmonic dissection in major breast surgery compared with electrocautery, nor was there any difference in the complication rates measured. © 2014 Royal Australasian College of Surgeons.

  17. Stationary facial nerve paresis after surgery for recurrent parotid pleomorphic adenoma

    DEFF Research Database (Denmark)

    Nøhr, Anders; Andreasen, Simon; Therkildsen, Marianne Hamilton

    2016-01-01

    .001). A not significant tendency for females to be associated with worse outcome was found (p = 0.073). Risks of different degrees of paresis after the second-fourth surgeries were found (OR 1.86-2.19, p

  18. Distribution of cagG gene in Helicobacter pylori isolates from Chinese patients with different gastroduodenal diseases and its clinical and pathological significance

    Institute of Scientific and Technical Information of China (English)

    Can Xu; Zhao-Shen Li; Zhen-Xing Tu; Guo-Ming Xu; Yan-Fang Gong; Xiao-Hua Man

    2003-01-01

    AIM: To determine the distribution of cagG gene of Helicobacter pylori(Hpylori) isolates cultured from patients with various digestive diseases and its relationship with gastroduodenal diseases.METHODS: cagG was amplified by polymerase chain reaction in 145 H pylori isolates cultured from patients with chronic gastritis (n=72), duodenal ulcer (n=48), gastric ulcer (n=17), or gastric and duodenal ulcer (n=8), and the relationship between cagGstatus and the grade of gastric mucosal inflammation was determined.RESULTS: cagG was present in 91.7% of the 145 H pylori isolates, with the rates were 90.3%, 93.8%, 88.2% and 100.0%, respectively, in those from patients with chronic gastritis, duodenal ulcer, gastric ulcer, and gastric and duodenal ulcer. There was no significant difference among the four groups (P>0.05). The average grade of gastric mucosal inflammation in the antrum and corpus was 1.819±0.325and 1.768±0.312, respectively in cagG positive patients,whereas the average inflammation grade was 1.649±0.297,1.598±0.278 respectively in cagG negative cases (P>0.05).CONCLUSION: cagG gene of H pylori was quite conservative,and most H pylori strains in Chinese patients were cagG positive.cagG status was not related to clinical outcome or the degree of gastric mucosal inflammation. Therefore, cagG can notbe used as a single marker for discrimination of H pylori strains with respect to a specific digestive disease.

  19. Significant alteration of soil bacterial communities and organic carbon decomposition by different long-term fertilization management conditions of extremely low-productivity arable soil in South China.

    Science.gov (United States)

    Xun, Weibing; Zhao, Jun; Xue, Chao; Zhang, Guishan; Ran, Wei; Wang, Boren; Shen, Qirong; Zhang, Ruifu

    2016-06-01

    Different fertilization managements of red soil, a kind of Ferralic Cambisol, strongly affected the soil properties and associated microbial communities. The association of the soil microbial community and functionality with long-term fertilization management in the unique low-productivity red soil ecosystem is important for both soil microbial ecology and agricultural production. Here, 454 pyrosequencing analysis of 16S recombinant ribonucleic acid genes and GeoChip4-NimbleGen-based functional gene analysis were used to study the soil bacterial community composition and functional genes involved in soil organic carbon degradation. Long-term nitrogen-containing chemical fertilization-induced soil acidification and fertility decline and significantly altered the soil bacterial community, whereas long-term organic fertilization and fallow management improved the soil quality and maintained the bacterial diversity. Short-term quicklime remediation of the acidified soils did not change the bacterial communities. Organic fertilization and fallow management supported eutrophic ecosystems, in which copiotrophic taxa increased in relative abundance and have a higher intensity of labile-C-degrading genes. However, long-term nitrogen-containing chemical fertilization treatments supported oligotrophic ecosystems, in which oligotrophic taxa increased in relative abundance and have a higher intensity of recalcitrant-C-degrading genes but a lower intensity of labile-C-degrading genes. Quicklime application increased the relative abundance of copiotrophic taxa and crop production, although these effects were utterly inadequate. This study provides insights into the interaction of soil bacterial communities, soil functionality and long-term fertilization management in the red soil ecosystem; these insights are important for improving the fertility of unique low-productivity red soil.

  20. Explanation of Significant Differences for the Record of Decision for Interim Actions in Zone 1, East Tennessee Technology Park, Oak Ridge, Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    Bechtel Jacobs

    2011-02-01

    Zone 1 is a 1400-acre area outside the fence of the main plant at The East Tennessee Technology Park (ETTP) in Oak Ridge, Tennessee. The Record of Decision for Interim Actions in Zone, ETTP (Zone 1 Interim ROD) (DOE 2002) identifies the remedial actions for contaminated soil, buried waste, and subsurface infrastructure necessary to protect human health and to limit further contamination of groundwater. Since the Zone 1 Interim Record of Decision (ROD) was signed, new information has been obtained that requires the remedy to be modified as follows: (1) Change the end use in Contractor's Spoil Area (CSA) from unrestricted industrial to recreational; (2) Remove Exposure Units (EU5) ZI-50, 51, and 52 from the scope of the Zone I Interim ROD; (3) Change the end use of the duct bank corridor from unrestricted industrial to restricted industrial; and (4) Remove restriction for the disturbance of soils below 10 feet in Exposure Unit (EU) Z1-04. In accordance with 40 Code of Federal Regulations (CFR) 300.435, these scope modifications are a 'significant' change to the Zone 1 Interim ROD. In accordance with CERCLA Sect. 117 (c) and 40 CFR 300.435 (c)(2)(i), such a significant change is documented with an Explanation of Significant Differences (ESD). The purpose of this ESD is to make the changes listed above. This ESD is part of the Administrative Record file, and it, and other information supporting the selected remedy, can be found at the DOE Information Center, 475 Oak Ridge Turnpike, Oak Ridge, Tennessee 37830, from 8:00 a.m. to 5:00 p.m., Monday through Friday. The ORR is located in Roane and Anderson counties, within and adjacent to the corporate city limits of Oak Ridge, Tennessee. ETTP is located in Roane County near the northwest corner of the ORR. ETTP began operation during World War II as part of the Manhattan Project. The original mission of ETTP was to produce enriched uranium for use in atomic weapons. The plant produced enriched uranium from

  1. Audit of patient acceptance of nasal surgery as a day case procedure.

    Science.gov (United States)

    Tierney, P A; Samuel, D; Patel, K S; Thomas, D M

    1996-01-01

    A greater emphasis on day case surgery within the health service is seen as a method of improving efficiency and reducing expenditure. We interviewed 90 consecutive patients undergoing nasal surgery who had been preoperatively assessed as being fit for day case surgery. They were randomised into three groups regarding the duration of postoperative nasal packing. All patients stayed overnight following surgery and were interviewed prior to discharge. Some 52% of the overall sample would be happy to have nasal surgery performed as a day case. If the nasal pack was removed after two hours, this figure rose to 67%. This difference in patient acceptance did not attain statistical significance overall, but there was a significant difference in those undergoing submucosal resection. There was no difference in the age, sex distribution or type of surgery performed between each group. The audit commission quotes patient satisfaction with day case surgery at 80%. Nasal surgery was not examined in their report, but was included as one of a set of procedures suitable for consideration. Although day case nasal surgery may be safe, further research regarding patient acceptance is required.

  2. Deep sternal wound infection after cardiac surgery.

    Science.gov (United States)

    Kubota, Hiroshi; Miyata, Hiroaki; Motomura, Noboru; Ono, Minoru; Takamoto, Shinichi; Harii, Kiyonori; Oura, Norihiko; Hirabayashi, Shinichi; Kyo, Shunei

    2013-05-20

    Deep sternal wound infection (DSWI) is a serious postoperative complication of cardiac surgery. In this study we investigated the incidence of DSWI and effect of re-exploration for bleeding on DSWI mortality. We reviewed 73,700 cases registered in the Japan Adult Cardiovascular Surgery Database (JACVSD) during the period from 2004 to 2009 and divided them into five groups: 26,597 of isolated coronary artery bypass graft (CABG) cases, 23,136 valvular surgery cases, 17,441 thoracic aortic surgery cases, 4,726 valvular surgery plus CABG cases, and 1,800 thoracic aortic surgery plus CABG cases. We calculated the overall incidence of postoperative DSWI, incidence of postoperative DSWI according to operative procedure, 30-day mortality and operative mortality of postoperative DSWI cases according to operative procedure, 30-day mortality and operative mortality of postoperative DSWI according to whether re-exploration for bleeding, and the intervals between the operation and deaths according to whether re-exploration for bleeding were investigated. Operative mortality is defined as in-hospital or 30-day mortality. Risk factors for DSWI were also examined. The overall incidence of postoperative DSWI was 1.8%. The incidence of postoperative DSWI was 1.8% after isolated CABG, 1.3% after valve surgery, 2.8% after valve surgery plus CABG, 1.9% after thoracic aortic surgery, and 3.4% after thoracic aortic surgery plus CABG. The 30-day and operative mortality in patients with DSWI was higher after more complicated operative procedures. The incidence of re-exploration for bleeding in DSWI cases was 11.1%. The overall 30-day/operative mortality after DSWI with re-exploration for bleeding was 23.0%/48.0%, and it was significantly higher than in the absence of re-exploration for bleeding (8.1%/22.0%). The difference between the intervals between the operation and death according to whether re-exploration for bleeding had been performed was not significant. Age and cardiogenic shock

  3. Systematic review of obesity surgery mortality risk score--preoperative risk stratification in bariatric surgery.

    Science.gov (United States)

    Thomas, Harun; Agrawal, Sanjay

    2012-07-01

    Bariatric surgery is the best long term treatment for morbid obesity. However, it carries risks of considerable morbidity and potential mortality. There is no published review on pre-operative identification of high-risk patients in bariatric surgery. This systematic review analyses obesity surgery mortality risk score (OS-MRS) as a tool for pre-operative prediction of mortality risk in bariatric surgery. Medline and Embase was systematically searched using the medical subjects headings (MeSH) terms 'bariatric surgery' and 'mortality' with further free text search and cross references. Studies that described OS-MRS to predict mortality risk after bariatric surgery were included in this review. Six studies evaluated 9,382 patients to assess the validity of OS-MRS to predict the mortality risk after bariatric surgery. Patient's age ranged from 19 to 67 years, and the body mass index ranged from 30 to 84. There were 83 deaths among the 9,382 patients (0.88 %) with individual studies reporting